17-year-old Mia Hall is an aspiring concert cellist living in Portland, Oregon with her parents and younger brother Teddy. When school is closed one day on account of the snowy weather, the family decides to go for a morning drive, but ice on the roads causes their car to swerve into another lane, where a car crashes into theirs. Mia awakens to find the bodies of her parents, who have died upon impact. Mia comes across her own severely injured body and realizes she is having an out of body experience. She follows her physical body to the hospital, where she watches her extended family rushing to take care of her while her best friend Kim and her boyfriend Adam struggle to reach the hospital. She also watches as doctors struggle to revive Teddy, who eventually succumbs to his injuries. Through her experience, Mia reflects on her life, reminiscing about the development of her relationship with Adam, the development of her passion and talent for playing the cello, and the obstacles of being a teenager who feels out of place no matter where she goes. Mia struggles to decide whether she will awaken from the coma to be with her remaining family and Adam, or whether to join her parents and Teddy in death. She very nearly makes the decision to pass on until Adam finally reaches her hospital room and tearfully begs her to stay. Mia then experiences a vision of how the remainder of her life will play out. The novel ends just as she wakes up.
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