As the fall of 1912 was opening up the Family was on schedule in Bialovezh, Russian Poland. The children were growing up. In September Olga Nicolaievna was only two months shy of 17. Alexei had just turned 8. His parents were basking in the quiet family life that God had granted them for that summer. Nicky took his daughters for bicycle rides every morning whilst Alexei would go boating on a nearby lake. One morning in early September, Alexei was a little too excited when out on his excursions. He jumped into a boat and, miscalculating a little, hit the inside of his leg on the oar lock. Like any other bruise it was tender, so Dr. Botkin was called to examine it. The physician noticed a swelling on the inside of his patient's thigh, just below Alexei's groin. For preventative measures the Heir was put to bed for rest. The doctor watched the injury carefully for a couple of weeks and was pleased when he noted the swelling diminishing. Alexei's spirits were undaunted and he showed no signs of being in any danger. The okay was given for the Family to continue to their Hunting Lodge, Spala.

The ride was a bit uncomfortable for Alyosha, and soon he was complaining of pain and general discomfort. Upon arrival in Spala Alix put her son back in bed, where he would stay until October opened up. Alix was a little concerned about him not getting enough fresh air in that dark and stuffy lodge. She thought maybe some fresh air would do him good. So placed in between his mother and Anya Vyrubova, Alexei was taken for a carriage ride into the lush forest surrounding the lodge. Unfortunately early 20th Century Poland was not known for its smoothe roads. The carriage rocked and jostled about over the uneven ground. After 8 miles out Alexei couldn't keep quiet any longer, and complained of an uneasy feeling in his lower abdomen and leg. Alix ordered the carriage back to the lodge. Alexei moaned, obviously in a lot of pain, and the panicked Empress told the driver to hurry. But each bump in the road caused the boy the most horrific pain. Alexei had a new haemhorrage in his upper left thigh. Dr. Botkin and Dr. Fedorov cabled a number of specialists in the capital, and soon a streamline of the best doctors in Russia were sent to Poland, but there was nothing any physician could do for him. He had torn vessels in his leg, and blood was flowing into his abdomen. The Heir was fighting for his life, the same Heir whose subjects thought was a perfectly healthy boy.

The days between the 6th and the 10th were the worst. The poor darling suffered intensely, the pains came in spasms and recurred every quarter of an hour. His high temperature made him delirious night and day; ..he would sit up in bed and every movement brought the pain on again. He hardly slept at all, had not even the strength to cry, and kept repeating, "Oh Lord, have mercy upon me."
~A letter from Nicholas II to his Mother~

During the entire time, the Empress never undressed, never went to bed, rarely even laid down for an hour's rest. Hour after hour she sat beside the bed where the half conscious child lay huddled on one side, his left leg drawn up.... His face was absolutely bloodless, drawn and seamed with suffering, while his almost expressionless eyes rolled back in his head.
~Anya's Memoirs~

Alicky didn't budge for days. She didn't change, never went to bed, and when she could literally no longer force her eyes open she allowed herself to rest on the sofa next to her son's sickbed. The expression of suffering pasted across Alexei's pale face would never leave her. She didn't know which was worse: the ear piercing shrieks, or the delirious moaning. All she could do was hold his hand, smoothing the hair away from his face. Tears flowed down her cheeks as she pleaded day and night for God to help her little boy. Sure she was in Hell, her only defense for her son were her prayers. Everyone saw how this was taking its toll on the Empress, her hair became streaked with gray and her face aged with worry. She took the crisis better than the Tsar did, Nicky admitted this himself. He could barely stay in the room. Anya remembered once when Nicky came to see his son, he stepped inside and his courage deceived him. The Tsar couldn't bear to even stay in the lodge, and rushed outside weeping.  

Death seemed near, this was becoming apparent to everyone close by... most of all Alexei. One of the worst things in the world is to feel your body break down, I know this from experience. Possibly the only thing worse is to see your child in such a state. In the breaking down process there is a point where your mind will reach peace with whatever will happen to your body. You realise that your fate is no longer in mortal hands.
~Lishka~

Amazingly, the Family and Household did their best to conceal anything happening to Lyosha. The staff at Spala plugged their ears with cotton to block out the screams. The girls tried to continue on as normal, they played tennis but lacked their usual smiles. They performed plays but lacked their usual exuberance. They couldn't concentrate on their lessons as they really didn't know what was happening with their brother. The only fact known to them was "Alexei Nicolaievich is not well."

Nicholas continued with his hunting in the mornings, and in the evenings Alix found she had to part with her patient as she played hostess for her husband. The Imperial Family was forced into a double life: putting on a front for their guests so nothing would be suspected whilst their hearts were breaking inside. However well they thought they were behaving in public, it was hard to keep the crisis a secret. The Imperial Capital started buzzing with gossip about the Tsesarevich. It was even rumoured that Alexei was attacked by a bomb.

6 October ~ Dr. Fedorov, the court surgeon, told the agonizing parents that Alexei's stomach was now haemhorraging. Finally, facing what seemed inevitable, Nicky and Alix had to tell their subjects what was happening to the Heir. They gave Count Fredericks the okay to begin releasing medical bulletins. The first was released on 8 October, with no mention as to the cause of the attack.

Russia was silenced into a time of national prayer for their Crown Prince. Special services were held in Cathedrals and Churches alike throughout the kingdom. There was no Church at Spala, so a makeshift one was erected out of a green tent.

8 October ~ The Empress sent the Tsar a quickly scribbled note telling how Alexei's suffering was too great, that surely it would be too much for him to endure. Nicky and Dr. Federov left the lunch table immediately for the sickroom. Alexei's condition did not improve.

9 October ~ It snowed all day. The Imperial Suite was collected in Empress's Boudoir. Princess Irene, Alexandra's sister, entered the room with a pale face, and begged everyone to retire. There was no news, other than the fact that Alexei was still not improving.

The final hour had come. There were only two possible outcomes, and though everyone's prayers were directed towards a miracle it seemed that death was eminent. It was out of the doctors' hands, no specialist could help him. All that was left was to wait.

A priest was summoned to the lodge to administer the Last Rites to the boy, should the need arise. The next day's press release was to announce the death of His Imperial Highness, the Tsarevich Alexei Nicolaievich, Sovereign Heir of the Russian Empire.

10 October ~ The Height of the crisis had worn down Alix. She was exhausted but calm, she knew her son's health was not in mortal hands any longer.

Finally, the waiting paid off: out of the blue Alexei's fever broke. The pain faded, and he closed his eyes peacefully. The swelling went down and the haemhorrage stopped. It was the first time Alyosha was able to really rest soundly in over a week.

For the pair most hit by the crisis, recovery was slow. Until Alexei was well enough to travel back to Tsarskoe Selo he sat up in bed propped by pillows. He couldn't bend his left knee and needed it to be propped up on a pillow as well. He was kept still for a month as the process of internal absorption cleaned up his insides. The colour returned to his face, but he was terribly thin from the ordeal. Alix sat beside his bed in a chair, reading aloud to him, knitting, and trying to coax him to eat.

Finally when the okay was given for the Family to go home to Tsarskoe Selo the Empress had the road from the train station to the palace smoothed so that nothing would disturb Alexei's recovery. The train that carried them home crawled at a whole 15 miles per hour.

From all the stress that the attack put on his left knee, it took a year before Alexei could walk with only a slight trace of a limp. He was given mud baths to try to ease the pain of recovery. At first it was impossible for him to straighten his leg, so a metal brace was put on. Official portraits of that time always showed the Tsarevich sitting, hiding the physical effects of his attack.