"River of Tears" was inspired by her difficult relationship with her late alcoholic father.

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The Cuicocha lagoon was born from a river of tears coming down the slopes of Mt Cotacachi.

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"When I think about young kids in America who are being bullied and tortured, who are taking their own lives because they feel alone and judged, outcast and misunderstood, I want to sit down and cry a river of tears, " Madonna said.

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The cuffs are adorned with black freshwater pearls harvested from the Mississippi River watershed, a nod to where her tribe lived before the Trail of Tears.

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