Was Maria put to sleep when this was being done? I don't know much about medical procedures in the early 1910s but I know chloroform existed, but how would that be able to hold her mouth open for it to be done? There's no other mention of anyone else other than Alexandra and the doctor being in the room, unless they used chloroform on her and they either used some sort of device to hold her mouth open or Alexandra herself held her jaw open, and why did she need her tonsils removed anyway? Did she have tonsillitis during that time?