When most theater fans outside of New York think of Broadway musicals, they picture big blockbuster touring shows like "Hairspray," "Hamilton" or "Wicked." But Broadway shows come in all shapes and sizes. And sometimes, it's the shows with small casts, minimal tech and sparse staging that have the most heart.

This is the case with the Tony Award-winning musical "Kimberly Akimbo," which runs Jan. 7-12 at Seattle's Paramount Theatre. This musical has a cast of only nine performers, and is regarded just as highly for its emotional gut-punch as it is for its award-winning music.

Part of what sets this show apart from typical touring musicals is that it wasn't originally intended to be one; it was first penned by David Lindsay-Abaire as a play. Years later, he set out to write a musical with Tony Award-winning composer Jeanine Tesori, and it was Tesori who suggested the duo start with material Lindsay-Abaire had already written.

"We were in his office," recalled Tesori over a Zoom call. "I pulled out one of his plays, and it was 'Kimberly Akimbo.' The story was great, but the mechanics of the piece itself were sort of early. He was still figuring out his craft and technique, so there was room for us to maneuver and there was room for music."

The story follows a teenager, Kimberly Levaco, as she navigates school, dating and life with a dysfunctional family -- all of which would be pretty standard for a fictionalized American teen. But Kimberly has a rare genetic condition that causes her to age rapidly. When the play opens, she is yet to turn 16, but is in the body of a 60-year old woman.

Tesori said her music was inspired by the visceral reaction she had to the script. She said the way the world would see someone Kimberly's actual age is a stark contrast to how people view her with her older appearance. "The world sees an older woman," Tesori said, "and therefore discounts her, because older women tend to be more invisible to the world. They're not full of promise."

It's within this gap -- between how Kimberly feels inside and how she is perceived by the world -- that births musical numbers like "Make a Wish." Her condition makes it so that she will likely not live past 16, but she still has the hopes and dreams of a teenager. "There's a morbid nature sometimes, but in reality, there's a beauty in being grateful for what's happening, because you know it's not going to be there forever," Tesori said. The musical walks the delicate line between drama and comedy, with the overall tone leaning toward the funny, though with the impending doom of early death looming under the surface.

Tony-nominated actor Carolee Carmello, who is currently in her 60s, plays Kimberly. She said playing the adolescent character has been both fun and challenging: "It's been a long time since I had that kind of unbounded energy that teenagers have. So far, I feel like I'm learning things that I didn't expect to learn at this stage of life."

Carmello saw the musical in New York twice (once off-Broadway and once on Broadway) before taking on its lead role herself for the tour. She said she was drawn to the role for the artistic challenge of being an older person attempting to capture the persona of a young person. "I've played teenagers in my older years, like as a flashback scene in a show, but it's never been for the whole length of the play," she said. "And I loved the writing. I thought it was so smart. So I guess that's what drew me to it. The idea of the challenge and the quality of the material."

"It's not just fluffy entertainment," Carmello said. "It really is a story that makes you appreciate life and makes you understand the challenges, but also the joys that life brings. And reminds you to hold on to the people around you and appreciate every moment."