In All Rivers Flow to the Sea Rose and her sister Ivy were in a car accident. Ivy now lays in a hospital bed with a brain hemorrhage, which makes her brain dead. She is alive but just barely. Rose goes back to her normal routine but she is always thinking about Ivy. She goes and visits her daily. Rose finds solance in Tom Miller whose father died, so he knows what it is like to lose someone you love. Tom helps Rose through the months that Ivy is in the hospital and she falls in love with him.