“I dreamed a dream my life would be … so different from this hell I’m living.” Twenty years ago, I would pull out my Les Miserables piano book and pound out “I Dreamed a Dream” while my fellow medical student/roommate would sing along with me to the line above with gusto. In the scheme of things, we didn’t have it so bad. We hadn’t been abandoned by our lover-baby daddies. We weren’t subjected to unwanted advances from factory foremen or fired from said factories. We weren’t being forced to sell our hair or our bodies into literal prostitution to support illegitimate children who were being maltreated by bawdy innkeepers’ wives. We weren’t dying of tuberculosis. But at the time, cramming our heads full of neuroanatomy and cardiac physiology or studying for the next big potentially career-ending standardized test seemed like more of a hell than a dream. Singing show tunes provided some brief respite from reality. In the end, we both graduated from medical school in four years and matched into the residencies of our choosing. I headed to Phoenix for pediatrics, and she moved to St. Louis for Neurology. I have seen Les Miz numerous times, starting in middle school when my great uncle Jack treated us to theater tickets that definitely were not in the budget. I have cried along to the heart-wrenching lyrics of Jean Valjean from the balcony of a community theater while eight months pregnant. Last week I took my 12-year-old daughter to her inaugural viewing when the Broadway touring company visited Omaha. I was a little apprehensive that it would be too long or a little inappropriate or possibly hard for her to follow. I tutored her in the plot basics over lunch at Jason’s Deli. I read parts of the Playbill to her as we waited for the lights to dim, reinforcing the crucial plot elements and pointing out the key cast members in the “bio” section. She had to turn down a sleepover with a classmate in order to attend, and I was worried that she would regret it. As the familiar strains filled the theater and Fantine’s wretched life played out on the stage in front of us, I was taken back to the living room of my medical school duplex. I could see myself sitting at the piano and my roommate singing/screaming along to our favorite line. But this time, as I watched Fantine and Jean Valjean and the prostitutes and the homeless, I thought about the miserable circumstances in which many of the characters had found themselves. I thought about the judgmental police captain, Javert, who could not reconcile Jean Valjean’s remote act of theft with his numerous instances of generosity and mercy later in life. I thought about those of us who are privileged enough to have been accepted to medical school and have been able to successfully navigate tests and classes and residencies and fellowships and end up taking care of human beings. We are often in the position of taking care of our fellow humans on their worst days, in their most miserable moments, when they have fallen from grace, when they are most in need of mercy and generosity. It is so, so easy to fall into the black and white mindset of Javert and believe that people are good or bad: That they can’t change. That drug seekers are always seeking drugs. That babies who are failing to thrive aren’t being fed. That all femur fractures are child abuse. The shades of gray are harder because we can’t cleanly disposition each of our fellow humans into a neat bucket. But in the shades of gray are real life, and they are what, in fact, make all of us human. It is a privilege and a sacred responsibility to take the time to unpack the layers of gray in our patients’ life stories, to believe in redemption, and to reserve judgment. As Jean Valjean sang his final scenes, I saw my daughter’s hand sneak up to the corner of her eye in a perfect replica of my own tear-wiping motion. “To love another human is to see the face of God.” We headed out into the frozen January night, and I glanced over at the 12 year old who was wearing my clothes and is nearly as tall as me. I asked, “Did you like it? Are you glad you came?” She quickly replied, “Yes.” Lisa Sieczkowski is a pediatrician. Source
