Mia Hall (Chloe Grace Moretz) begins by saying that Beethoven was deaf at the age of 26, but that didn't stop him from pursuing his dream of being a composer. This is what has driven Mia to pursue her dream of being a skilled cellist. She lives in Portland, Oregon with her parents, Denny (Joshua Leonard) and Kat (Mireille Enos), and little brother Teddy (Jakob Davies). Denny used to be in a band called Nasty Bruises, while Kat was a punk rock girl who became a travel agent. Mia reads a newspaper with her ex-boyfriend Adam (Jamie Blackley) on it. Adam's touring with his band, even getting to open for The Shins.
Flashback to high school when Mia first met Adam. He saw her playing the cello in her classroom long after everybody has left. Her best friend Kim (Liana Liberato) tells Adam who Mia is. Kim pulls Mia out of class and walks with her, snapping a picture of Adam on the way out. All the girls are gaga over Adam, but he ignores them to go introduce himself to Mia. He notices her locker has a sticker that says "I Love Yo Yo Ma", prompting him to invite her to see a cello player. She is surprised that Adam is asking her out, though she accepts.
Mia waits at home for an acceptance letter to Julliard. As it is snowing heavily outside, schools are closed. Denny suggests they take a drive together. Kat offers to let Mia pick the music on the trip. They drive and she plays Beethoven. She reminisces over watching her dad play in his band as a kid. In second grade, she saw a cello for the first time and wanted to play it. Since cellos are expensive, she had to borrow one from school. She would play for hours, to the point where it drove her parents nuts, but they were still proud over what their daughter could do. Denny even went and bought Mia her own cello as a gift. As Mia thinks to herself how funny it is that life is one thing and then it becomes something else, a car swerves on the road and collides head on with the family's car.
Mia has an out-of-body experience and sees herself lying in the snow as paramedics are on the scene trying to save her and bring her family into the ambulance. She calls for her family and then climbs in the ambulance to be near her body.
We see Mia getting ready for her first date with Adam. Kat helps her pick her outfit. Adam comes over and meets Denny, flattering him by mentioning him love for Nasty Bruises. Adam takes Mia to see the cello player, and afterwards, they take a walk and share their first kiss. He later takes her to see his own band, Willamette Stone, perform. Mia feels awkward and uncomfortable around the people there. She even notices Adam's bandmate Liz (Ali Milner) getting close to Adam. Mia brings this up when he takes her home. Adam says Liz is a lesbian, and she is seen making out with her girlfriend. Adam invites Mia to a party with them, even though it's past her curfew. Kat is watching from the window and encourages Mia to go. Mia fakes having come down with something and stays in. Kat steps out and invites Adam to come over for a Sunday meal before he leaves. Mia tells Kat that wasn't cool and she goes inside. Kat doesn't think it's bad that Mia would hang out with Adam and his friends because they're just like her and Denny. Denny replies, "Exactly."
At the hospital, Mia undergoes surgery while her OOB self frantically searches for her family. The nurse tells whispers in her ear that it's up to Mia to decide whether or not she wakes up. Her grandparents (Stacy Keach and Gabrielle Rose) arrive to check on the status of the family.
In more flashbacks, we see the progression of Mia and Adam's relationship. He goes over her house for the Sunday dinner, welcomed by Mia's parents and their friends. While they sit down for their meal, a bee stings Mia. Adam sucks the stinger out of her hand, to the amusement of everybody watching (especially Kat). Mia later wants to be closer to Adam's world, so Kat helps her dress up like Debbie Harry for a Halloween party, while Adam is fittingly dressed as Beethoven. However, Adam thinks Mia is perfect as she is and doesn't need to change for him. They make love for the first time in a shed.
Kim and Adam both rush to the hospital to see Mia, but as she is in the ICU, they are not allowed to see her since they are not part of her immediate family. Mia continues to find out what happened to her parents. She sees Denny in the room with a patch over his eye. She overhears the doctors say that both Kat and Denny are dead, and that if Mia wakes up at all, she is going to be an orphan. Fearing for Teddy, Mia runs to his room to check on him and promise to never leave his side.
Mia and Adam had begun to think about after high school. They had hoped to live together as Mia goes to Lewis and Clark College while Adam continues with his music. Mia still continued trying to improve her music, even when she thought she wasn't good enough. With the encouragement of her family, she applies to Julliard. She is later invited for an audition in San Francisco. She goes to find Adam while he plays with his band to tell him about this. He is visibly unhappy that Mia has told him about her decision after already having made it. The next time she sees him play in a band, they have a fight over her choice to go as well as his choice to go off and continue his music with the band.
Kim creates a distraction at the hospital so that Adam can sneak into the ICU and see Mia. The mean nurse calls security on him and he is pulled out forcefully. Before he and Kim are taken away, Mia's parents' friend Willow (Lauren Lee Smith) comes in to vouch for the two. Then she breaks down in Kim's arms. Mia runs downstairs and sees Teddy's room empty. The doctors talk to her grandparents and inform them that Teddy had an epidural hemorrhage and they couldn't save him. Mia breaks down and realizes Teddy will never get to grow up and live a full life. This sudden shock physically disturbs Mia, and the doctors take her out of the ICU for further medical attention.
Mia had her audition at Julliard with her grandfather taking her. She plays an incredible composition, which Gramps watches from a TV backstage. He drives her home and tells her that the judges are fools if they don't accept her.
Mia and Adam later reconciled, though there was an obvious strain on the relationship. Eventually, they broke up, which hurt Mia as she was really in love with Adam. Kat tells her that life is messed up but that's also the beauty of it.
Many people visit Mia at the hospital, from her grandparents and Willow to Kim and even Adam's bandmates. Gramps tells Mia that Denny quit his band for her, and the whole family was right behind her for her musical career. Kim later sits by her friend's bed and promises her that she has a family if she wakes up. She takes out her phone and shows a picture of Mia smiling and looking happy. Mia remembers this from a Labor Day party, which she says was the happiest day of her life. Denny and Adam convinced her to play the cello with them for a performance. They play "Today" by Smashing Pumpkins, and everybody has fun.
Adam is finally able to see Mia and sit by her side. He pulls out a letter from Julliard, as he admits he stole her mail. He opens it and weeps as he reads it, because Mia has been accepted. He vows to go with her if she chooses to go to New York. Then he takes out his guitar, having written a song for Mia. It's a beautiful piece, and it causes Mia's life to flash before her very eyes until...a flash of white. And then, after a brief moment of silence, Mia's eyes finally open. The first thing she sees is Adam standing over her, calling her name.
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