If I Stay is set in a small, contemporary Oregon town outside Portland and chronicles 17-year-old Mia’s struggle with life and death after a horrible automobile accident kills her parents and younger brother, and leaves her, the only survivor, in a coma.

The narrative structure moves back and forth in time between her comatose present and her formative years growing up in a quirky musical family, developing into a gifted and dedicated cellist, meeting her best friend, Kim, and her relationship with Adam, her beloved rock musician boyfriend. 

While Mia’s physical body is lying comatose in a hospital bed, Mia’s consciousness is able to leave her body and observe unseen the suffering of her friends, family, and boyfriend as they cope with the possibility of her death and desperately attempt to coax her back to life.

The novel is divided by the hours of one 24-hour day, beginning on the snowy morning of the accident at 7:09 A.M. and ending with Mia’s awakening from the coma at 7:16 A.M. the next morning. The author, Gayle Forman, compresses a lifetime of Mia’s memories into this brief time period, a figurative journey into the most meaningful moments of her past as she battles for life in the present. 

During this 24 hour limbo in the hospital, Mia has the power to choose whether to stay or to go—whether to live or to die—and her time is spent on the cusp of mortality, agonizing over whether it is better to live in spite of tremendous suffering and devastating loss, or better to let go of that burden in death. While the novel concludes with Mia choosing life and waking from the coma, it is a difficult choice made only after a serious contemplation of leaving the burden of living behind.