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Poetry and Medicine
November 4, 1998

Alexandra at the Bedside

JAMA. 1998;280(17):1478. doi:10.1001/jama.280.17.1478

"She lived in the particular sunless world reserved for the mothers of hemophiliacs."—Nicholas and Alexandra by Robert K. Massie

In Petersburg winter lasts forever,
over the palace that bears its name,
entering the river and heart
of the land,
a darkness no amount of light can fill.
Everyone is lost
inside their furs, everyone's last breath is
like a deafening clamor in the air,
the petty miracle
of life, and even peasants walk on water.
But here lies my son bleeding in his skin.
Here the future
Tsar, blessed by God Himself, bulges with pain,
a boy frenzied
at the least touch of his mother's hand.
There was blood
sprouting from his navel as he lay
in his cradle,
balloons of blood where his knees should be.
No one knows.
Nicholas bears the secret of his son
in silence for the sake of all Russia.
I bear the blame.
No bicycles,
no hunts with his father, no daredevil
sledding down long hills,
no dancing, no somersaults, no wild gallops
beside the sparkling southern sea.
The child's smooth skin gleams with fever
but his eyes are old.
I will never save him.
The last time,
With all his doctors gathered like storm clouds
above the bed,
our friend Rasputin saved Alexis
with a song,
a martyr's prayer.
But He is gone now, lost to the fury
around us. They found his riddled body
in the river,
all my hopes held still within his frozen soul.

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