What are the motifs in Nicholas and Alexandra by Robert K. Massie?

Hemophilia is a motif in the book.The disease of hemophilia and its effects is the underlying theme of the book. The Heir Apparent, Alexis, had the disease and this affected the actions of his parents, the Tsar Nicholas and the Empress Alexander. The disease, which appeared in the family of Queen Victoria, affected a large part of European royalty. The disease caused Alexandra and Nicholas to come into contact with the starets Gregory Rasputin, the faith healer.