Set in 2014-16, and in the fictional town of West York, KY, All Lies Begin with Truth dramatizes the complexities of natural gas extraction, its legalities and impact on a small town's economy, infrastructure, and surrounding environment. Split into three distinctive perspectives, the novel begins with Eris Carroll, the outsider, a young and energetic activist negotiating her place in a world where societal rules and cultural norms cater to and support patriarchy. Later, the perspective changes to Lionel Boone, whose past indifferences and mounting guilt over surviving a kettle bottom collapse taunts him daily. Lastly, the novel switches to Cass Taylor, a West York resident whose cultural role in life was predetermined before her birth and who struggles with the realities of being trapped in small town USA and within the confines of a patriarchal culture. Her somber, foreboding outlook on the town, her life, and the human spirit is often chilling as the realization becomes clear that as a civilized species, we are imprisoned, being all too dependent on energy and those corporations who provide it for us.

In July of 2003, 40-year-old Gio Pagano unearths the remains of a black-and-white film, which possibly contains an authentic snuff scene. This scene, which Gio edited almost 20 years ago, had been investigated by the FBI and ruled a fake, though Gio had suspected it was real but never pursued the matter further. In the months that follow the reemergence of this scene, Gio researches his 20-year-old baptism into the world of cruelty, violence, and death that he now fully occupies (in his job as correctional officer at Rikers Island, in his 19-year marriage to his estranged wife, and in the impending death of his uncle, his last living relative).

The storyline shifts between Gio’s attempt in determining the authenticity of this scene by tracking down former employees of Scratch Films (the company that employed him as a film editor) and his apprenticeship (1983-84) at Scratch. CJ Scott, the charismatic owner of Scratch, had assured Gio that “what they did” was simply create “simulated” snuff, and that no one ever got hurt. However, as the apprenticeship ensues, the simulated snuff scenes become more realistic due to the film crew’s proficiency with more realistic artistic techniques and stage props.