Letters to Minnehaha Creek is a poetry collection structured in four sections of poems through the passing seasons. In many of the poems, the narrator addresses Minnehaha Creek directly, reminiscing about her deceased friend, Dorothy, as she walks the same neighborhood routes they once traveled together.

The tone of the poems reflects the seasons. Fall takes place in the aftermath of Dorothy's death and explores the narrator's longing for her friend. Winter highlights the narrator's sadness and acceptance that Dorothy is truly gone. Spring follows, with a lighter tone as the narrator embraces life after the loss of her friend. Summer offers a sense of renewal, with poems that are letters written from the creek, rather than to it. The titles reset to one again, almost as if the manuscript experiences a rebirth.

The setting and symbolism portrayed in Letters to Minnehaha Creek complement the writing style. For example, the speaker says, "A pair of mallards swim by / as I find my way up the stairs. // A female cardinal / in scalloped flight moves // across the sky alone, surprised / at times her partner is gone." These vivid images of scenery surrounding the narrator also reflect the speaker's emotional state. The symbolism of the pair of mallards and the female cardinal flying alone contrasts the speaker's loneliness with the companionship she once had.

Letters to Minnehaha Creek will resonate with readers who have lost someone or lived with a loved one suffering from illness as it illustrates a vivid path towards healing and rebirth.