Bob Ferrante and Autumn Klein married in a small, candlelit ceremony at the Old North Church in Boston on Friday, May 18, 2001.
The historic church founded in 1722 was neutral ground — Bob was Catholic, Autumn was Methodist.
Autumn wore a fitted, straight gown with elegant bead work, her hair swept up beneath a long veil, and Bob wore a traditional black tuxedo. She searched Boston high and low for a bouquet of sweet peas because that was Bob's nickname for her.
Her cousin and best friend, Sharon King, served as maid of honor and Michael, Bob's 18-year-old son, stood as his father's best man.
About 50 friends and relatives attended the ceremony and then headed to a restaurant nearby for the reception. The couple, 23 years apart in age, gave out as favors a CD they made called "Love Across Generations," featuring songs from Diana Krall, Sam Cooke, Billy Joel, Dean Martin, Perry Como, Barry White, Celine Dion and Savage Garden.
Among their guests was the Rev. F. Washington Jarvis, the headmaster at Michael's school, who gave the couple a piece of his grandmother's china as a wedding gift. Each year after, Bob sent the priest a Christmas card with a picture of the piece in various settings.
"That's the kind of thoughtful, sweet guy he was," Father Jarvis said.
Although Autumn's family and friends had reservations about her marrying an older man, none of them ever interfered.
"Who am I to tell her who to love?" her mother, Lois, said. "I accept people for what they present to me, and he presented to me OK."
Everyone knew that part of Autumn's attraction to Bob was his intellect.
"I trusted her judgment," Sharon said. "What I saw was, they matched brain pans, and that's what she needed."
Also, Bob encouraged Autumn in her work, knowing what it would take to become a successful physician and researcher. He didn't object to her working an 80- or 100-hour week.
Sharon, who had also married an older man, was able to help Autumn through the early hurdles of the relationship.
They discussed Bob's two children — Sharon's husband had three from his first marriage — and how to acclimate into the family.
"You go in delicately, not trying to be a mother," Sharon told Autumn. "You be you and let them come around when they're ready. That was the approach we both took."
Autumn had moved into the Ferrante home about a year before she and Bob were married, staying in her own room in the house when Michael was still in high school. Bob's dad, "Papa," whom Autumn adored, lived there as well.
As the wedding was getting near, Leslie Hand, a close friend of Autumn's from Amherst, asked about their registry.
"'Autumn, don't you want your own dishes?'" Leslie asked.
"'Bob is right. He has perfectly fine dishes from his first marriage. We'll just use those,'" Autumn had said.
After the wedding, the couple, who had signed a prenuptial agreement, continued to live in the same home where Bob had raised his first family.
Two days after they married, Autumn graduated from Boston University with her M.D. and Ph.D.
Bob presented her with her diploma.
After that, Autumn began a one-year internship at Brown University, about 35 minutes from their Canton home, and later went on to do her neurology residency at Partners — a program of Harvard Medical School, Brigham and Women's, and Massachusetts General hospitals — where she became chief resident in 2004.
Some in her family thought Autumn would pick neurosurgery as her specialty.
But she didn't.
"'It's not challenging enough,'" Autumn told Sharon on the phone one day. She chose neurology because she wanted to be the one to make the diagnoses.
"She said 'we have to tell them where to operate,'" Lois said.
Autumn ultimately chose to specialize even further, narrowing her field to women's neurology.
Following a yearlong fellowship to study epilepsy, Autumn, along with her department chairman, founded the Women's Neurology program at Brigham and Women's.
Karen Roos, the editor in chief of the journal Seminars in Neurology, based at the Indiana University School of Medicine, first met Autumn when the younger doctor was chief resident at Partners and Dr. Roos was a visiting professor.
"I instantly liked her," she said. "She was just delightful."
Autumn engaged completely in every conversation, every encounter.
"I never heard her say anything negative ever," Dr. Roos said.
Her colleagues in Boston praised Autumn, who went on to earn her master's in public health from Harvard, for her dedication to her field, with one calling her a "human dynamo" for trying to focus on women's health in all areas of neurology.
Among the patients she specialized in were pregnant women with epilepsy.
When Enia Allberto, who had epilepsy, became pregnant at age 32, her doctor told her she should terminate because the seizure medications would harm the baby. Six other physicians she spoke to advised the same.
By the time she first went to see Autumn, Enia was in her second month of pregnancy and having grand mal seizures every other day.
"Pretty much nobody wanted me to keep the baby," Enia said.
Autumn was different.
"'Women who have seizures deserve to be mothers like everyone else,'" Autumn told Enia.
"She told me she would walk through the journey with me and do the best she could."
When Enia said she felt alone, "She was like, 'Hey, I'm here. You're not alone.'"
Autumn kept track of Enia's meds, adjusting levels regularly, checked up on her OB visits and her ultrasounds, and saw her every month.
"She was my hope in the middle of chaos," Enia said.
Although her seizures continued through the first trimester, they stopped in the second. Enia gave birth to Ryan, a healthy baby boy. The next day, Autumn visited her.
"We looked at him and looked at each other. She said, 'Look at him. He's here. He's beautiful.'
"She was the best doctor anyone could possibly ask for. She looked at you as a person, not as a walking disease."
In January 2007, Autumn gave birth to Cianna Sophia Marie Ferrante.
Autumn was in love with motherhood, and couldn't wait to share the joys and frustrations she experienced during Cianna's early years when she learned her good friend Karen Kiang was pregnant.
"You are going to have SO much fun with this. Work will seem like the most boring thing in your life," Autumn wrote in one August 2008 email.
In another, she said of Cianna, "She is so cute, I just want to hug her and kiss her all the time."
She talked about the time it took to bond with Cianna, too.
"Everyone talks about the 'bonding' like you instantly feel like you should be totally gaga over this little thing — well, you are, I was, but whether it is the hormones or everything else going on, my mommy love didn't fully kick in for a few months. It is kind of hard to explain, I loved Cianna, but not like I do now."
She also wrote about the difficulty in trying to balance work and family.
"Bob is always annoyed [because] he thinks I work too much and get home too late and don't spend enough time with the baby, but hey, when she is sick or wants someone, she comes to me, so I must be present enough."
That topic was a recurring one for Autumn.
Taking a tip from her mentor, Dr. Roos, she began taking Cianna with her to the office. The little girl would play on the floor or color, while Autumn wrote and edited.
Although Bob, who was 58 when Cianna was born, had been hesitant to have another child, he took to fatherhood the second time around with vigor. The couple balanced their jobs so that Bob was home with Cianna in the afternoons after day care and into the evening for dinner and bath time, while Autumn got her ready in the mornings and returned for bedtime stories.
Cianna became best friends with the little girl who lived across the street from her who was three weeks older.
The girls played outside together, and Bob would join in, playing hide and seek, pushing them on the swings and taking hundreds of photographs of them and their friends.
There were frustrations, though.
Autumn hated that she had to spend as much as three hours of her day commuting through Boston traffic.
In her typical style, she made the most of it by using her drive home to first take care of patient calls and then call her cousin, Sharon, to chat.
Regularly, those calls would be interrupted two and three times by Bob calling Autumn to check to see where she was.
"'Five minutes further down the road than last time,'" she'd tell him. The repeated calls from Bob frustrated Sharon. She asked Autumn pointedly why he kept calling.
"'He just wants to know where I am,'" Autumn would answer.
Sharon told her that Bob was trying to exert power and control over his wife. She called it domestic abuse.
Autumn brushed it off.
"She was the kind of person that she would not sweat the small stuff," Sharon said. "She didn't have time for that. It was petty. There were bigger things in life to worry about."
When Sharon and her husband, Jeff, would visit Bob and Autumn in Boston, they never felt completely at ease with him.
Bob didn't go with Autumn back home to Baltimore — not for Sharon's mom's funeral, or for Sharon's wedding, even with Autumn as the maid of honor — or for visits to see Sharon and Jeff.
They described Bob as always wanting to be in control.
"He was never wrong. Don't challenge him on things because he's going to be right. He's going to win," Sharon said.
Jeff, a clinical psychologist, described Bob as arrogant with a narcissistic personality and obsessive tendencies.
Autumn's parents, Lois and Bill, complained that Bob always had his nose in his computer and would not interact with them when they'd visit.
Bob could annoy Autumn, too. He was an obsessive housekeeper.
"'I can't even put my teacup down without him coming up behind me and telling me where it belonged,'" Autumn said.
By August 2008, Autumn was ready to have another child, but Bob wanted to wait. He had been hesitant to have Cianna and became frustrated when people would ask if he was the girl's grandfather.
In mid-2010, Autumn and Bob were contemplating a move to Pittsburgh. The University of Pittsburgh Medical Center wanted Autumn to join the neurology practice and start a women's program, and the University of Pittsburgh wanted Bob to move his lab in Boston to Scaife Hall.
The idea of moving to Pittsburgh, where there would be less backbiting among her colleagues, more money and a significantly shorter commute appealed to Autumn.
She also knew that Bob would probably retire within a few years, and once that happened, she would be the sole breadwinner for the family. A bigger salary, in a city with a lower cost of living, was enticing.
On Jan. 25, 2011, Bob signed a contract to take his lab, valued at $3 million, along with nine grants in his name, to the University of Pittsburgh.
A week before they moved to Pittsburgh, Bob was talking to his neighbor and told her that Autumn was pressuring him to have a second child, something he bitterly opposed.