The Blood That Brought Down a Dynasty, Part One

On Robert K. Massie's Nicholas and Alexandra and the literal body politic.

Hi everyone!

While I reflected last week on the bodies of fictional protagonists, this week I’m going to look at a real-life historical body, its real-life impact on history, and its story as told by one of my favorite books.

Enjoy!

A Weathered Paperback Full of Memories

I first encountered Robert K. Massie’s 1967 bestseller Nicholas and Alexandra, the story of the last tsar and tsarina of Russia, as a yellowed paperback on my grandmother’s bookshelf. Every summer, my father and I would drive the 12 hours from Jacksonville, Florida up to Grandma and Grandpa’s mobile home in Bedford, Virginia, a rural blot between the cities of Roanoke and Lynchburg.

I loved those two weeks. I’d sit with my grandmother on her bed and listen to her stories about her childhood, or go through her jewelry box and learn the origin story of her most treasured pieces. Clusters of nutritional supplements and lotion bottles she used to keep her skin young spilled out from the bathroom into the bedroom, filling up her nightstand or fighting for space on the top of her vanity.

Their well water had a slightly sulfurous taste that was actually delicious. We’d eat green beans and corn from their garden. I’d spend hours wandering their yard, looking at the red clay and walking into the ice cold root cellar below the deck. I’d play with the strays that Grandma took in, even though they set off my allergies something terrible. Most of all I’d sit in the rocking chair in the living room and sway back and forth as I read.

I can’t remember at what point Grandma allowed me to take Nicholas and Alexandra home, but it’s one of my go-to re-reads: a handful of books that I will pluck off the shelf every so often, not to read again cover to cover but to savor my favorite bits.¹

Books are lovely physical objects. This mass-market copy has lost its front cover, but it still has a musty smell that is probably just aging paper but makes me think of Grandma’s house. The edges of the pages are dyed a faded sea green: a fad long forgotten? I still have a bookmark in there from November 2012, a printed receipt from a Long Island Rail Road ticket to Jamaica Station (on the way to JFK airport, presumably to fly home for Thanksgiving). When I open the book up, the pages crackle. It’s a full-on sensory experience even before I get to the words.

As for the story itself, it’s one of those you couldn’t pass off as fiction because it would strain the suspension of belief. That’s mostly because of two figures.

The first is Alexei Nikolaevich Romanov, Nicholas’s only son and heir who never became czar. Raised in unimaginable wealth, you’d think he’d won the genetic lottery. Just look at him:

(Alexi in 1913; credit: Boasson and Eggler, St. Petersburg)

But genetics don’t spare the nobility. In fact, thanks to centuries of inbreeding between the princes and princesses of Europe, they fared far worse than most people with far less.

And Alexei had one of the worst genetic diseases you could have at that time: hemophilia.

A Mother’s Agony

To be fair, I don’t think there’s ever a good time to have hemophilia, a genetic disorder that prevents the blood from clotting. As a result, simple bruises can be life-threatening injuries because the blood just does not stop flowing. A hemophiliac could bleed to death from a simple nosebleed or a bump.² Nowadays, “most children born with hemophilia in the US today can look forward to long, healthy and active lives,” according to the National Bleeding Disorders Foundation. However, even as recently as 1960, the life expectancy for someone with severe hemophilia like Alexei was 20 years old.

When Alexei was born in 1904, doctors had not yet isolated the blood proteins, known as Factor 8 and (less often) Factor 9, that induce clotting. Blood infusions weren’t even attempted until the 1940s. Therefore, at the time, the only treatment for hemophilia was preventative; it boiled down to “don’t get hurt.”

Scan your body for bruises or sore spots — many of which you probably don’t even remember getting. Now think of the boisterous energy of a young boy. That gives you an idea of just how impossible that mandate is.

Alexei was a hemophiliac because Queen Victoria had a spontaneous genetic mutation that meant she passed down to the disease through the generations of her children and grandchildren. Hemophilia is an x-linked disorder, which means that women like Queen Vic carry the gene but only men have the disease. Victoria’s son Leopold died of the disease at the age of thirty-one, when a small bump on the head from a fall became a brain hemorrhage. Her daughters Alice and Beatrice inherited the gene, and Alice passed it onto her daughter Alix, who later became the tsarina Alexandra Fedorovna.

(mother and son on a good day; credit: Heritage Images and Getty Images)

While Alexei is, as Massie writes, “the most famous hemophiliac of all,” three of his uncles and four of his cousins also had the disease, including the heir to the Spanish throne. But none of these hemophiliacs were as politically important: they belonged to less prominent royal families or were not the only surviving male heir.

Massie’s book is called Nicholas and Alexandra and not Alexei, and it does give an excellent overview of the political mistakes and confluence of circumstances that resulted in the Russian Revolution and the fall of the 300 year-old Romanov dynasty. The cast of characters is massive, from multiple ministers like Sergei Witte and Pyotr Stolypin, political figures from Lenin to Alexander Kerensky, and the larger Romanov family.

The heart of the story, however, is personal for Massie, and it’s Alexei’s hemophilia. Here are the opening words of the introduction:

“The writing of this book is the result, like most things in life, of a circumstance of Fate. Since the day, now over ten years ago, that my wife and I discovered that our son had hemophilia, I have tried to learn how other families dealt with the problems raised by this unique disease. In time, this led to curiosity about the response of the parents of the boy who was the most famous hemophiliac of all, the Tsarevich Alexis,³ the only son and heir of Nicholas II, last Tsar of all the Russians.”⁴

And the truth is that, as fascinating as the book is, Massie is most compelling in a chapter called “A Mother’s Agony,” in which he explains the toll that hemophilia took on the family and especially on Alexandra. As he notes, the tsarina was a deeply devout woman who agonized over her initial failure to do the one job required of her in providing a male heir.⁵ Over the first nine years of her marriage, she’d produced four daughters: Olga, Tatiana, Maria, and (thanks to some bogus rumors and a pretty cute 1997 movie, the most famous Romanov child) Anastasia.

So, as Massie writes,

“Because she had waited so long and prayed so hard for her son, the revelation that Alexis suffered from hemophilia struck Alexandra with savage force. From that moment, she lived in the particular sunless world reserved for mothers of hemophiliacs.”⁶

For pages, Massie describes just how “sunless” this world can be. As awful as it is when your child is in agony from a bleed (because the unending blood flow pushes against nerves, corrodes joints), there’s no rest even in between bleeding episodes: you’re always living in anxious dread of the next stumble.

The tension that all parents feel between protecting their children and letting them burn their fingers on the proverbial stove — letting them learn by experience, no matter how painful — is exponentially exacerbated when your child bumping an elbow against a table corner could kill them. Spanish royals encased their hemophiliac boys in padded clothes when they were toddlers, hoping that would keep them safe.

Alexandra limited her son’s male friends and assigned him two sailors to shadow his every move. But any child can shake off a bodyguard, and it’s impossible to ask an energetic child to treat himself like glass.⁷ One of Alexei’s worst bleeds occurred when he jumped into a boat, and collided with the oar. It initially seemed to heal, but a week or so later it hemorrhaged so badly he received last rights. He was 8.

Since Alexei was born at a time when no real treatment was available, the only potential medication he could have taken was opiates to ease excruciating pain. Sadly, he was never given these, supposedly because they were seen as addictive and weakening. (True, but still — that’s a lot of pain to ask a child to bear.)

Worst of all was the need to keep all of this a secret. Russia was an autocracy: power was embodied in the tsar, and any physical or psychological weakness of the tsar’s body meant that Russia itself was weak as a nation.⁸ It was assumed that if the Russian people knew that their tsarevich had a deadly disease, they would lose faith in the Romanov dynasty as a whole. We’ll never know, of course. But we do know that the secrecy exacerbated the Russian people’s dislike of Alexandra, since they did not understand why she hid away from balls and other court appearances so often. She seemed aloof when she was understandably distracted, obsessed with the health of her beloved son — a health that also equated to the health of Russia itself.

Speaking of health, Alexandra’s own was destroyed by her son’s illness. When he was having a severe bleeding episode, she would sit by his bed for days, barely sleeping and rarely moving, as he would cry out to her. When he was well, she would sit for hours in her private chapel, praying.

As Massie puts it,

The toll on the Empress was like battle fatigue; after too long a period of sustained alertness, her emotions were drained. This often happens to soldiers in war, and when it does, they are withdrawn from the front to rest. But for the mother of a hemophiliac there is no withdrawal. The battle goes on forever and the battlefield is everywhere.⁹

The problem with such a personal tragedy is that it was equally a political one. As a result, on the fate of this young boy rested that of millions of people.

Massie sums this up perfectly:

The fall of Imperial Russia was a titanic drama in which the individual destinies of thousands of men all played their part. Yet in making allowance for the impersonal flow of historic forces, in counting the contributions made by ministers, peasants and revolutionaries, it still remains essential to understand the character and motivation of the central figures. To the Empress Alexandra Fedorovna this understanding has never been given. From the time her son was born, the central concern of her life was her fight against hemophilia.¹⁰

When I first read Nicholas and Alexandra, I hadn’t been diagnosed with Crohn’s Disease. My gut was an unhappy set of organs, but it hadn’t completely imploded yet. Once I was diagnosed, my trips to my grandmother essentially ended; I wasn’t well enough to travel for the first few years of my illness.

I do wonder, however, if one reason I loved this book so much was the ability to read about another child going through a serious illness. My friends were all healthy, and it left me feeling incredibly isolated. And angry. Massie doesn’t talk too much about Alexei’s frustrations, but he would complain and cry about how he wasn’t allowed to do anything: no riding bikes or horses, no jumping around. “Why can other boys have everything and I nothing?” he would sob.

The irony is powerful: this child’s father ruled a massive nation, and his family had the money and power to have everything they wanted. Except the ability to heal their son.

This irony was especially devastating for Alexandra, who literally gave her son the gene that resulted in this terrible disease. As a child, I had no patience for my mother’s suffering on my behalf. She wasn’t the one curled up on the bed with abdominal cramps, and she certainly wasn’t the one sitting on the toilet for up to an hour shitting diarrhea. “You don’t understand!” I’d scream at her.

But now, I get it. She’d lie awake all night and listen each time she’d hear the bathroom door close, wishing she could shit diarrhea for me. Bearing witness was unbearable, yet that was all she could do when it came to taking on my pain. (She did many other excellent things, using her medical knowledge and maternal ferocity to get me into the best clinics and to keep me from the operating room, which happens to so many people with Crohn’s Disease.)

When I re-read Massie’s chapter “A Mother’s Agony” now, I understand what he means — and I understand my mother and my friends whose children have serious health issues — not just intellectually but emotionally. I don’t have kids, but I’ve felt the pain of seeing my beloved black cat Mochi groggy on anesthesia and flailing around after surgery to remove a suspicious bump on his ear, as well as the terror when his biopsy came back as (thankfully very low-grade) cancer. Cats are not kids, but even that sliver of what parents can feel was sobering.

Alexandra’s situation was made far worse by the lack of medical understanding around hemophilia (and most diseases), leaving her with little but a hope and a prayer for relief for her and her son.

So, in the absence of treatment, how did Alexandra fight this disease’s stranglehold on her son?

Next week, we’ll look at the mystical hobgoblin who became Alexandra’s lone, disastrous hope for her son’s health: Grigori Rasputin. His is also a story of a remarkable body.

Recommendations

Nicholas and Alexandra, obviously. Some of its historical information is outdated, but the perspective of a man whose child also has hemophilia makes it a particularly poignant story. And he’s surprisingly even handed about Lenin in the midst of the Cold War. Massie also released an updated version in 1997, but even that would be outdated by now.

However, as someone who remains obsessed with the Romanovs, I can also recommend some newer books. One I really enjoyed was Helen Rappaport’s 2014 The Romanov Sisters: The Lost Lives of the Daughters of Nicholas and Alexandra. Rappaport uses some great source material to give us a full picture of these often overlooked members of the family who deserve a three-dimensional portrait.

I’d also like to give a shoutout to Nancy Norbeck, who mentioned the death of English actor Michael Jayston about a month ago in her Substack The Spark. She brought up his role as Nicholas in the 1971 British epic Nicholas and Alexandra, based on Massie’s book. (You’ll also see Succession’s Brian Cox as Trotsky and Doctor Who’s Tom Baker, who played the Fourth Doctor from 1974-81.

It’s available for free on YouTube, and I watched most of it. While it follows Massie’s book well — and is called one of the last great movie epics reminiscent of The Ten Commandments (1956) and Ben Hur (1959) — it moves the plot along so quickly that it makes the actions of many years seem like a rapid-fire strafe of changes without a break. It also portrays Alexandra as a bit of a nagging wife, a portrait that seems a bit exaggerated compared to the book. Whatever else you can say about Nicholas and Alexandra, they clearly loved the shit out of each other and never stopped. Despite massive pressures that would break or poison many marriages, theirs not only held strong but also never wavered. Plus, Alexei gets weirdly psychopathic at the end, an interpretation that is very far off from Massie’s depictions of him. Don’t come for the history, come for the melodrama.

This Week’s Dose of K-Pop: BTS (방탄소년단), “DNA”

Well, this was an obvious pick. Maybe a bit too on the nose, but hey — I won’t always have such good synergy merging K-pop songs and my newsletter topics.

This song is often portrayed as BTS’s breakout international hit, and it’s a fun tune. I especially love the choreography, which I would describe if I knew the techincal terms.

I’ve never even looked at the lyrics, so it’s quite a surprise to learn it’s a love song. But the lyric that stands out to me is “이 모든 건 우연이 아니니까,” or “None of this is a coincidence.”

When it comes to hemophilia, coincidence is rarely a factor. But if you are someone who experiences a random mutation, then it certainly must feel like a shitty coincidence.

And when it comes to many chronic illnesses, including cancer, we’re increasingly learning that some genes sit quietly in our bodies but are actually loaded and cocked weapons: ready to unleash uncontrollable cell growth (cancerous tumors) or autoimmune disorders if the right environmental factors — pollution, stress, poverty, poor diet, allergens — are in place.

It’s too simple to boil everything down to genetics. Look at Alexei’s uncles and cousins: even if they died young of hemophilia, their disease didn’t help bring down a 300 year-old dynasty. You need the wrong country and the wrong time to do that.

Speaking of coincidences: one of my first encounters with hemophilia was also through a story found at my grandmother’s house, in one of her Reader’s Digest issues. I’ve tried to find the story online, but no luck. It was written by a father about his son’s battles with hemophilia in the 70s and 80s; even with the regular treatment of plasma transfusions, there were a lot of difficult times where his life was in danger and he faced terrible pain.

But the end came when his son — who, if I recall, was in college and had met the woman he wanted to marry — tested positive for HIV. Blood banks had known that HIV was transmitted through blood transfusions — they had tested their blood — but still fought screening because gay men in particular were some of their most reliable donors. The victims of this medical malpractice is a story worth telling in its own right, and one I might explore if I ever review Randy Shilts’s magisterial (if again, outdated) 1992 book And the Band Played On: Politics, People, and the AIDS Epidemic.

Love y’all,

Sara

1. Most of the others: Orwell’s 1984, Flaubert’s Madame Bovary, Shaara’s The Killer Angels, and Brontë’s Jane Eyre.

2. Cuts are not an issue, as pressure can be applied to stop the bleeding. But you can’t press against a bruise and have the same effect.

3. Massie gave a Romanized or Englished version of Alexi’s name, calling him Alexis.

4. Nicholas and Alexandra, vii.

5. Tsar Paul I, who hated his mother Catherine II (aka the Great), passed a law in 1797 forbidding female heirs from inheriting the throne.

6. Nicholas and Alexandra, 153.

7. Perhaps with the exception of Charles VI of France, whose mental illness led him to believe he was made of glass. His daughter married Henry V, the king who led the English to the victory at Agincourt in 1415, and likely passed on his madness to her son, Henry VI. His mental issues were a major reason for the Wars of the Roses.

8. A Duma, or parliament, was created in 1905, but the tsar had control over when it could meet.

9. Nicholas and Alexandra, 154.

10. Idem, 164.