Choices: The conflict of making choices is a prominent theme in the book. The entire crux of the novel hinges on Mia's decision about where she will choose to go. Her choices become a reflection of her true character; whether she has the strength to go on in her life without her family, or whether the burden of losing them will be too much to bear. There is also an element of choice throughout many of Mia's flashbacks. The choices about whether to go to Juilliard or to stay with Adam. The choices about whether she stays true to her passions of classical music or whether to step outside the box and try to immerse herself in the world of rock.
Life and Death: This is an obvious theme in the book. Mia is confronted by the idea of life versus death and is given the rare opportunity to choose which she wants to embrace. She faces death in a very abnormal way, dealing with not only the death of her family, but the potential death of herself. She also must deal with the idea of life, and all the possibilities it can bring for her.
Growing Up: Mia is forced to face the reality of growing up way before her accident, although it becomes much clearer that her life will require her to grow up very quickly should she choose to stay in they physical world. Mia struggles with leaving her childhood behind as she reaches the end of her high school career and is on the brink of entering an adult world, where she will not only be in a new place, but be completely alone, where she must fend for herself.