Piecing together a real-life death of a promising doctor

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Paula Reed Ward, author and reporter who covered the case for the Pittsburgh Post-Gazette.

On the night of April 17, 2013, Autumn Klein walked the half mile from Pittsburgh Medical Center where she worked as a neurologist to the home she shared with her husband and young daughter. Once in her kitchen, Klein, 41, collapsed, and her husband, Robert Ferrante, 23 years her senior and a research physician, called for an ambulance. A few hours later, Klein would be declared dead, kicking off the mystery at the heart of Paula Reed Ward's gripping true-crime debut.

Ward, a reporter who covered the case for the Pittsburgh Post-Gazette, makes use of court records as well as her own reporting and interviews with everyone from the couple's colleagues to members of the jury. She presents the ins and outs of a homicide investigation and trial as if they were a puzzle, one that investigators put together piece by piece to its satisfying end.

From the outset, Ward's technique of focusing on details in simple, declarative sentences holds the reader in suspense. When Klein arrives at the emergency room and cannot be revived, a doctor checks to see whether she is brain dead: "He pinched her. There was nothing. He checked her pupils, shining a light directly into her eyes. No response. No gag reflex." This approach both leads the reader through what happened and lets the facts shine through.

At first, Klein's death was not considered suspicious. An underlying health issue was suspected, although none could be found. It took a fluke follow-up to start the investigation. Klein's body had already been cremated when a doctor who had treated her in the emergency room saw that the results of a blood test had come back. Even though the patient was already dead, he examined the lab work anyway. What he found set the investigation in motion: "The cyanide in Autumn's blood measured at 3.4 milligrams per liter. A fatal level."

With this finding, Pittsburgh police were notified. Longtime homicide detective Jim McGee took the lead, and he and his colleagues were soon looking into every aspect of Klein's life. Suicide was a possibility. Klein, who had completed a dual M.D./PhD program at Boston University in 2001, was both driven and brilliant, which was one of the reasons Ferrante agreed to work with her when, during the PhD part of the program, she was assigned to his lab at the Bedford Veterans Administration hospital, where the two became romantically involved. Klein, however, had shown no signs of wanting to end her life and, instead, had plans involving both her friends and her 6-year-old daughter, Cianna.

Perhaps more to the point, McGee noticed that Ferrante's reactions were odd: He seemed ignorant of the poisoning, even though by that point everyone at the hospital was aware of her cyanide level.

A search of his workplace turned up that Ferrante had purchased cyanide for his lab, despite that no one there was doing any studies that required it. On her computer, investigators found e-mails revealing her unhappiness with the marriage — particularly with his resistance to having a second child. On his computer, they found Google searches for "divorce Pittsburgh pa" and, later, "detecting cyanide poisoning." At trial, suggestions emerged that Ferrante feared his much-younger wife was having an affair.

Fans of television shows like "Law & Order" can almost hear the trademark bass line — "boom, boom" — here. But Ward goes beyond the sensational facts. From the start, she builds sympathy for the victim with stories from friends, family, and patients. One patient, Enia Alberto, recalls how another doctor had told her she should terminate a much desired pregnancy because she had epilepsy. Klein disagreed and successfully treated the woman — monitoring her medication — until Alberto gave birth. "Look at him," Alberto recalls Klein saying during a visit. "He's here. He's beautiful.''

The details about Autumn's own life are also quite moving, perhaps all the more so for being presented in such an unembellished fashion; they include the couple's seemingly happy decadelong life in Boston, before the move to Pittsburgh in 2011.

Ward also manages to compound our sense of loss by focusing on Cianna. Describing how, for instance, assistant district attorney Lisa Pellegrini bonded with the child, Ward writes that the girl "took off the prosecutor's sunglasses, and put them on herself. 'I'm a supermodel,' she said, posing, while Pellegrini snapped her picture. The image remains on her desk."

Ward also turns to a video in which Autumn is teaching Cianna how to read. "I want to read because I want to learn," the little girl tells her mother. Having lived through this tragedy, she may well read this book some day and learn how those around her mother did their work thoroughly and well.

DEATH BY CYANIDE: The Murder of Dr. Autumn Klein

By Paula Reed Ward. ForeEdge/University Press of New England, 250 pp., illustrated, $27.95