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The prototype of the Moscow myrrh-streaming icon of the Tsar-Martyr was painted in 1996 in California, by the icon painter Pavel Tikhomirov, commissioned by representatives of the Russian Orthodox Church Outside of Russia.
The love and care accorded to his dying wife softened her husband's callous heart. He cried with gratitude and grief when he knew the name of the sister of mercy who treated her as if she were her mother: Elisabeth Romanov.