2 October 1881

After breakfast, we were in the royal coach with the gilded Romanov crest, galloping off to the Gatchina palace some twenty miles south of St. Petersburg.

Once we arrived, a silent, rather cowed, young aide-de-camp led us to the tsar’s study. The royal family’s quarters were not what I had expected, but were simple and plainly furnished.

Alexander III, Emperor of Russia and King of Poland, is a mighty figure - tall, solid, with a long, reddish-brown beard and a high forehead. He was not covered with medals, as I had expected, but wore a simple military jacket with no decorations. The tsar sat on a plain chair in front of a desk covered with documents.

Professor Pirogov stepped forward, bowed, and introduced us. The tsar spoke in French and Dr. Bell replied in French. The tsar went to the point. “Dr. Bell, can you cure my son?”

“I can operate, but only God can cure your son,” Dr. Bell replied.

The tsar’s heavily-lidded eyes showed a flicker of respect. “True,” he said, and beckoned to his aide-de-camp. “Fetch my son George.”

The tsar went back to his papers while we waited. A rather plain-looking governess carried the sickly, pale boy in her arms. He was an attractive little fellow dressed in a blue sailor suit but was stick thin and rather lethargic for an eight-year-old.

“Remove his shirt please,” Dr. Bell, rather unceremoniously asked.

The flustered governess looked to the tsar, who nodded. Dr. Bell said not a word, but examined the boy’s neck, then listened to his chest, and prodded the abdomen.

“Dr. Pirogov, do you agree these lumps are infected tuberculous nodes?”

The old surgeon clasped his hands in thought. “I do agree and have advised an operation.”

“It should be done. Make your arrangements,” the tsar said, and held out his arms for the boy, who eagerly went into his embrace. The tsar fondly stroked little George’s hair and murmured into his ear before handing him back to the governess and returning to his work.

I could’ve been mistaken, but there was a bit of moisture on the tsar’s cheeks after the boy left. There and then, no matter what I had heard about him, I concluded that Tsar Alexander was not a bad man, and I resolved to do my best to protect him.

Dr. Bell, with Pirogov and an elderly footman, selected a bright, airy room immediately across a corridor from the tsar’s private quarters for an operating theater. Dr. Bell wasted no time but scheduled the operation for the next day.

So, now we shall see Dr. Bell in action. I would never want to have to perform surgery under such pressure, but he seems to relish the challenge.

We shall see...