Dementia at the Opera: The Lion’s Face

Backgrounds and Fundamentals

The Lion’s Face is an opera about Alzheimer’s disease, with music by the Russian composer Elena Langer, a graduate of the Moscow Tchaikovsky Conservatory and London’s Royal Academy of Music, and libretto by the award-winning poet, dramatist, and novelist Glyn Maxwell.¹ The opera engages with dementia, and the treatment of and research into dementia, from the perspectives of a patient, a relative, a caregiver, and a clinician-scientist. It was premiered at the Brighton Festival in May 2010 and closed its initial run with a series of performances at the Linbury Studio of the Royal Opera House at Covent Garden, London. The title is taken from John Bayley’s memoir of the novelist Iris Murdoch, in which “lion’s face” is represented (erroneously) as a clinical term, because “the features [of Alzheimer’s sufferers] settle into a leonine impassivity.”² In this view, the sufferer’s face becomes a mask indicative of an absence. There may also be resonances of the observer’s fear of an illness that, through the disintegration of memory, strikes at the continuity of personality fundamental to the human sense of identity.

The opera was commissioned by The Opera Group (London) and developed with medical input from Professor Simon Lovestone and his colleagues at the Institute of Psychiatry, King’s College London, and the Biomedical Research Centre for Mental Health at the South London and Maudsley National Health Service Foundation Trust, UK. Through the Institute of Psychiatry, Elena Langer and Glyn Maxwell were given access to researchers, clinicians, and care workers, and to a particular Alzheimer’s sufferer in her late fifties, with whom they discussed her condition. Public showings of sections of work in progress, including at the Royal Institution of Great Britain in 2009 and the Brighton Science Festival early in 2010, also allowed responses from the scientific and medical communities and from the general public, including people directly affected by the illness, to be fed into the work’s evolution. The health care professionals involved often saw arts portrayals of psychiatrists as characteristically either godlike or demonized, and they wanted a presentation that was more neutral. Beyond this, the broad aim actuating the engagement of the scientific and medical communities was to contribute to the public understanding of Alzheimer’s disease. By so doing they hoped to reduce the stigma attached to the illness that may prevent early treatment and compounds the difficulties inherent in being a caregiver, and to foster the cultural awareness that underpins the needs of research.

Scenario and Characters

Central to the opera is the Alzheimer’s sufferer, Mr. D, a patient in a care home whose dementia has reached an advanced stage. While the case of Mr. D is presented specifically, he also assumes a representative status. Certain typical problems are made to arise, particularly language dysphasia ( partial aphasia) and the sufferer’s inability to recognize himself in a mirror (autoprosopagnosia), because he thinks of his appearance as he was when young. Mr. D is a speaking role: his speaking amid everybody else’s singing is a way of representing the gulf between him and the other characters, and his alienation from what, in an operatic context, is the normal discourse. It may also help the audience to identify with Mr. D: his mode of expression is theirs.

Around Mr. D are four other characters, all individuals but all also representing typical responses to his condition, and all defined by their relation to Mr. D. They are his wife, Mrs. D; a Clinician-Scientist, for whom Mr. D is both a patient and a research subject; a Nurse, Mr. D’s Caregiver; and the Caregiver’s Daughter (who is in the care home illicitly because of an enforced day off school caused by a snowfall, and so has to be kept hidden by her mother). The three women are somewhat conventional figures: the daughter representing youth—neither trammeled nor informed by preconceptions, encountering and making sense of new experiences; the nurse, middle age—working, with responsibilities; the wife, old age—witnessing or experiencing ill health and disintegration.

While all the characters assume a degree of typicality, none is represented as ideal. Mrs. D is at times exhausted and impatient, the Caregiver brusque and insensitive. The Clinician-Scientist, who combines the roles of doctor responsible to the individual patient and researcher responsible to the wider community, does not always balance those opposite imperatives well; nor does he always achieve the compassionate detachment required to deliver what is best for his patient purely in medical terms. The Caregiver’s Daughter, the only person who is not involved with Mr. D either personally or professionally, though characteristically adolescent, is also the audience’s representative onstage. Her responses are at first uncomprehending. Her progress within the drama to a more imaginative response can also be the progress of an ideal audience. A duo, trio, and eventually quartet of boys, only one of whom appears, act as reflective witness-commentators. The boy who appears is associated with Mr. D and his memories of childhood, but the words sung by the group (“at the end of the day / when it’s time … You will want to go home” [ p. 27]) suggest rather Mr. D’s present state: the end of an allotted life span, time for death. So while the immediate juxtaposition of childhood and old age has an effect of pathos (memories, the past, what is lost), the boys also offer a perspective reconciled to what is happening in the present. Their characteristic music (with static accompaniment, fluid indeterminate pulse, and harmonic pedal reinforcing a sense of repose) suggests messengers of death as a welcome, calm, a release.

The stage action is of unusual complexity. Though set predominantly in the present, it moves seamlessly into moments existing in no fixed time, imagined reenactments of the past, and video projections of Mr. D’s childhood and the onset of his dementia. Mr. D has no memory of present events or of most of his past. He does not recognize his wife. Everybody he meets he encounters as though for the first time. He reverts constantly to a traumatic childhood memory of a birthday party at which he gave a girl a present that she rejected—an early experience of love and disappointment. This sense of bewilderment and loss is registered in the staged layering of realities, from depictions of the external signs of Mr. D’s condition, to the repeated trauma of the birthday party, to the range of personal and professional responses to Mr. D. This repetition and layering present the situation as static and unresolvable, but, in moving from innocently cruel incomprehension to compassionate understanding, the Caregiver’s Daughter models the possibility of a developing reaction to Mr. D and his condition. The opera thus gives grounds for hope in care, if not in cure.

Drama and Documentary

The involvement of the scientific and medical communities was essential to a work that relies on an accurate presentation of the central issues of Alzheimer’s disease: its symptoms, their care, and the experience of patients, relatives, caregivers, and clinicians. It also points to a fundamental problem: the aims of the composer and librettist were only documentary within limits. That would be the mode of a different kind of work—the mode, for example, of Tony Harrison’s Black Daisies for the Bride, a screenplay about Alzheimer’s disease, which is a mixture of documentary (filmed in a care home), drama (recreations of the past), poetry meditating on both the documentary and the drama, and (preexisting) music.³ With The Lion’s Face composer and librettist faced a different problem— the difficulties of producing a work of art from a subject that they necessarily approached in part through a documentary mode.

The most problematic issue in relation to the work’s documentary aspects is its presentation of what constitutes “research” into Alzheimer’s disease. The psychoanalytic model implied by the Clinician-Scientist’s sense of the importance of investigating Mr. D’s recurrent memory is distinctly different from the biochemical modes primarily employed in current work on the illness. The potential here for a clash between the needs of drama and of documentary was far from subsidiary, since the whole structuring of the libretto around a recurrent memory—so important to how currents of sympathy flow throughout, and to how the healing denouement is achieved—implied a psychoanalytic model of diagnosis and treatment.

The main scientific consultant, Simon Lovestone, was apparently happy that one research model should do duty for another: that in a dramatic context the precise nature of (offstage) research is less important than the dilemmas to which the needs of research give rise—problems about consent to treatment and research with a patient who is not self-responsible; problems about treatment (the good of the individual) in relation to research (the good of the community). The assumption that what remains of memory is emotionally not chemically determined is fundamental to Mr. D’s birthday party memory and the uses made of that memory to structure the work around different characteristic responses to it. It is a compromise with documentary realism that must be judged in relation to the dramatic gains it yields.

Alzheimer’s and Opera

Alzheimer’s disease is, by its very nature, a problematic subject for opera and probably for any kind of drama. While opera has often dealt with illness— witness La traviata and La bohème)—and poetic drama has similarly famous precedents dealing with mental derangement in old age (most obviously King Lear), these well-known examples engage with forms of illness and mental derangement quite different from Alzheimer’s disease. In Verdi and Puccini, tuberculosis could be presented as in part attractive: white skin, pink flushes; adding intensity to life because of the awareness of approaching early death.⁴ Similarly with King Lear: the protagonist’s madness is depicted as revelatory, a form of wisdom, a vision not dulled by habituation. It is associated with the heroic—a refusal to submit to injustice and cruelty, and a refusal that sees beyond its own pain to injustice and cruelty in society and the cosmos. In The Lion’s Face, illness and mental derangement have no such aspects of the romantic, the revelatory, or the heroic—quite the contrary. They make the sufferer less, not more, than his usual self. While even this may have its moments of beauty—a “poetry” of unusual perceptions; the romance of intense, isolated fragments of vivid memory—these are at best oases in a situation that otherwise appears unrelievedly grim.

One major aspect of this problem was to produce some variation of tone, (so that the work would not sink into a uniformity of effect that was merely morbid or depressing, but to achieve this without compromising the documentary aspects of the work’s medical and scientific aims and its fundamentally realistic presentation of the illness. In terms of subject matter, this is achieved when the learning process experienced by carers offers the audience a model for compassionate response. In terms of form, complementary to a partly episodic structure (a sequence of short tableaux that Glyn Maxwell describes as “postcards”), the work as a whole has an expressive shapeliness. The music and the drama together are structured in such a way that heightened anguish is complemented by repose or release, and even by moments of comedy. Varied repetitions of material in the libretto, and even more in the score, produce expressive effects of structuration within and across the two acts. Finally, and for first-time audiences perhaps principally, the work is aesthetically satisfying because, without shirking the immitigable painfulness of the subject, it is structured around two interacting birthday parties (one in the present, one in the past), which lead to two moments of release from suffering: one minor, between Mr. D and Mrs. D, as a prelude to one major, a moment of communion between Mr. D and the Caregiver’s Daughter. It is a structure of varied repetitions, based around Mr. D’s recurrent memory, that point up parallels, contrasts, and developments of response to Mr. D and his condition. The problem of repetition inherent in the subject is thus put to musical and dramatic use.

The Score

The work’s powerful and expressive structure derives in large part from the music.⁵ In the opening “movement” (using the numbering system of the score, sections 1 to 6), the shape is an arch: the music for §6 is a reworking of that for §1, and the music for §4 is a reworking of that for §2. The audience is thus given the sense of an opening sequence that introduces the central characters (Mr. D, Mrs. D, and the Caregiver) and comes to a close before the introduction of the Caregiver’s Daughter brings in a major new element of the drama. The symmetries are not simple (§4 changes the tessitura of §2’s vocal line and is rescored to reflect the greater agitation of the characters), but even on a single hearing they are recognizable. This is simply one of the clearest examples of what happens constantly, when later music reworks or develops from earlier passages. The music of a meditative interlude for Mr. D (§5) is reworked at the close of the next dramatic “movement” (§9) and as a prelude to the final section of act 2 (§36). Music associated with the boys and Mr. D’s childhood (§1, §6, §14, §21, §27) reappears in act 2 (§33, §37). The Caregiver’s Daughter’s song is reprised (§7, §38), as that later music reworks or develops from earlier—when the music of a meditative interlude for Mr. D (§5) is reworked at the close of the next dramatic “movement” (§9) and as a prelude to the final section of Act 2 (§36); when music associated with the boys and Mr. D’s childhood (§1, §6, §14, §21, §27) reappears in Act 2 (§33, §37); when the Caregiver’s Daughter’s song is reprised (§7, §38); and similarly with music associated with Mr. D’s distress (§20, §28, §35), and music associated with Mr. D’s attempts to recall “Happy Birthday” (§22, §31).

Individual musical strands also recur. When §2 is reworked at §4, the variation incorporates an arpeggio motif prominent in §1 (and later elsewhere). Music associated with Mr. D’s suffering (§20, §28, §35) is evolved from a repeated-note and rising phrase that occurs first in §2. While an audience may not distinctly notice more than a limited amount of this use of motivic figures, an attentive listener will receive an impression of quasi-symphonic development, an impression that can only be deepened by repeated listening. These effects of structuration are also reinforced by a pattern of musical echoes. The principal example of this points to the central focus of the work’s dramatic structure: Mr. D’s recurrent memory of the traumatic incident at a childhood birthday party, when the birthday girl, whose hand he wanted to hold, rejected the present be brought by throwing it to the ground. Each of the other characters responds to this memory in some indicatively different way.

Mr. D’s birthday party memory recurs twice in each act: in act 1 with health care professionals, in act 2 with people who engage with him more personally. The first auditor is the Clinician-Scientist. Even at this first appearance of the memory, there is a disjunction between how Mr. D is treated onstage (as a subject for scientific investigation) and how the audience is given opportunity to respond (with sympathetic imagination). The Clinician-Scientist treats Mr. D here as both a patient and a research subject. The crucial memory is sparked by a comprehension test within the research questions (“Close your eyes”; “Can you read … ?”; “Can you do … ?” [ p. 34]). When “close your eyes” reminds Mr. D of the childhood game of hide-and-seek, he reenacts the memory, and the audience is drawn into his vivid reexperiencing of the occasion: the first of several video projections recreates the childhood party that he imagines. When the memory is sparked for the second time in act 1, it is by the Caregiver’s preparations for Mr. D’s birthday party in the present: Mr. D then remembers a new aspect of the childhood party—thunder, lightning, and rain. The music is partly transcribed from and so precisely recalls the memory’s first appearance (rescored: clarinet for oboe; double bass for bassoon), but with a major new element that acts like the video projection: a pattering vibraphone endorses Mr. D’s imagination of “raindrops.” The audience formerly saw Mr. D’s point of view. Now it hears it. Similarly with the first appearance of the memory in act 2: Mr. D is prompted this time by his struggle to recall who Mrs. D is—ironically, since she is painfully excluded from the memory. Greater richness of scoring (all three treble woodwinds: flute, oboe, clarinet) reinforces the heightened emotional dynamics of Mrs. D’s repudiatory response (“Why should I listen?” [ p. 49]). The “raindrops” are more agitatedly present in the vibraphone line, now rescored with shorter note values and more percussively for the piano. Precisely as Mrs. D negates it (“There is no lightning” [ p. 49]), Mr. D’s imagined experience of the past is again endorsed by the music—by “thunder and lightning” in the orchestral percussion.

The final reenactment of Mr. D’s birthday memory is with the Caregiver’s Daughter in the role of the birthday girl, who now accepts the “present” (Mr. D’s slipper wrapped in newspaper). This is the most positive aspect of the end of the opera, reversing both the trauma of the past and its recent repetition in the present (when the Caregiver’s Daughter rejected Mr. D’s present, precisely like the girl in the memory, by dropping it [§31]). The music sketches ghostly recollections of the earlier scenes of the memory (its offbeat pulsating notes in the accompaniment; its falling woodwind scales, now in the vibraphone). It is mainly drawn, however, from a motif (chords built up note by note from the bass) associated with the Clinician-Scientist’s efforts to help Mr. D (§11, §18), now played in an eerie pianissimo by an electronic organ. The Caregiver’s Daughter achieves her moment of empathy with Mr. D by acting on the Clinician-Scientist’s advice: she accepts the imagined reality of the Alzheimer’s sufferer as fact. Though the memory of this reversal of childhood trauma does not (and could not) stay with Mr. D, its effect for the Caregiver’s Daughter is a lasting gain in compassionate imagination. And even though the experience may not be retained by Mr. D, it implies for him some sense of healing in the present. Even as the libretto suggests a further disintegration of language (from words to vowels), Mr. D joins for the first time in the work’s fundamental mode of musical drama by humming (§39), his moment of imaginative unity with the Caregiver’s Daughter symbolized by his recalling the melody of her second song, “I wish I had a friend” (§22). Impressive as each individual scene is in isolation, the power of the whole sequence arises from these patterns of musical and dramatic recall and development.

The use of musical motifs is related to the movement toward this specific climactic incident, and to the overall structuration produced by the recall and reworking of previous passages. These are not motifs, as in Wagner, that have particular associations. They are fragments of musical material, easily recognized (for example, a rising arpeggio figure that appears first in §1; a triplet figure in thirds with distinctive harmonies that appears first in §3) and developed throughout in ways that resemble the manipulation of musical material in instrumental music. The arpeggio figure, for example, while often associated with reappearances of the boys (as at §14), also returns with the Clinician-Scientist (§18) and with Mrs. D (§26A). Associated with moments of repose or reflection, it has no particular dramatic significance but rather an emotional character. Motifs also have or can assume (by changes of pitch, rhythm, harmony, orchestration, or dynamics) a musical character expressive of specific dramatic situations. For example, the triplet figure from §3 is developed in a way that expresses Mr. D’s growing agitation in a scene in which, supposing himself a boy, he confronts a supposed old man—that is, he fails to recognize himself reflected in a window (§21). Some music has even more definite associations, for example music associated with Mr. D’s distressed state: brooding repeated-note crescendos that explode and subside in an anguished and rhythmically irregular rising and falling figure. Scored at first for double and triple stopping on the violin (§20), an elaborated transposition to the corresponding strings of the cello (§28, §35) reinforces the music’s rhapsodically passionate character.

Other forms of repetition suggest more precise dramatic meanings. The vocal lines of the Caregiver’s Daughter’s two songs (§10, §22) end with extended repetitions of the same notes (F-sharp, C-sharp), with a similar static accompaniment of string harmonics, drawing them into connection. After the disturbing experience each registers, both end with the Caregiver’s Daughter inserting herself back into a child’s world, retreating from the full impact of unwelcome knowledge. The extended recall of the second song, when the Daughter rejects Mr. D’s present, carries quite a different meaning: played in dissonances of a semitone by a piano and toy piano, it suggests both her uncomprehending cruelty and his pain. The varied repetition of her “Snow” song (§7), more richly orchestrated and pitched a semitone higher (§38), just before she accepts the role Mr. D assigns her in his birthday party fantasy, has the opposite effect: recalling the juvenile carelessness from which she began marks her gain in understanding. This kind of creative reworking and recall, some of it straightforward, some of it subtle, produces a sense of coherent musical development, sometimes with specific dramatic purpose.

Although the score is “advanced,” and in an obviously contemporary classical idiom, it is not forbiddingly so for an audience unfamiliar with contemporary classical music. There is plenty to draw in the attentive willing listener on a first hearing, not least the orchestral colorings for solo strings, quadruple woodwinds, trombone, and a large (twenty-seven-piece) percussion section. The Caregiver’s Daughter’s songs are straightforwardly melodic, and several other parts of the score also offer memorable melodic material. Music is used to depict different states of feeling in ways that are both inventive and readily comprehensible: swirling pitch mixtures of strummed piano strings accompany cello and double bass quarter-tone oscillations for Mr. D’s confused state of mind, immediately contrasted with the diatonic harmonies and the emphatic oompah-pah rhythm of a waltz for the Caregiver’s breezy detached professionalism (§16). Individual numbers are often beautifully characterized by their scoring: the shimmering effects of piano and glockenspiel for the Caregiver’s Daughter’s “Snow” song; or, at Mr. D’s party, the rhythm of “Happy Birthday,” at first would-be jolly on sleigh bells, followed by forlorn petering-out attempts at the melody on the swanee whistle. There are multiple effects of this kind, so that the music remains always interesting, even for those listeners who do not take in the cumulative relationships set up by reworkings and motivic recall and development.

The score’s main problem in performance is that of coordinating the speaking role of Mr. D with the fixed timings of the music. Speaking roles in opera have often addressed this difficulty of music-text coordination by being either lightly accompanied (the conductor follows the speaker) or dramatically isolated (the speaker is not required to integrate). In The Lion’s Face, where orchestral and vocal parts are fully integrated with a spoken role, either the actor must be able to read (or aurally memorize) the score to coordinate with it fully, or the conductor must train the actor (like a singer) to accept visual direction for entries and a discipline that curtails variation of delivery. Failures of coordination may produce the unintended comic effect of a singer responding to an actor who has not finished speaking, or waiting for the music to catch up with an actor who has finished speaking too soon. If the performer of Mr. D cannot read a score or memorize its sounds, these are significant dangers.

The Libretto

The libretto seriously confronts the problems that Alzheimer’s disease poses. While Mr. D is always central, he exists within a web of relationships that impinge, directly or indirectly, on his treatment, and the libretto engages sympathetically with the other characters’ relations to him. Mrs. D is torn between opposite difficulties: she tries (in telephone conversations) to persuade her sons to act with loyalty toward their father, but, experiencing the problems of doing so herself, she is also driven to pose the central question about change of identity and continuity of relationship and commitment: “It isn’t him at all / so why should it be me?” ( p. 40). She gives at least one answer: “I love what’s left of him” ( p. 59); but several scenes show the difficulties of doing so, most painfully a scene in which Mr. D, thinking of himself as the boy at his childhood girlfriend’s birthday party, asks his wife “Are you her grandmother?” ( p. 51). Mrs. D evokes particular sympathy as she tries to come to terms with her loss—in effect, a “death” of the person she knew, who has disappeared mentally and emotionally, though bodily he is still there, needing her care. The whole scenario, text and action, brings out the fundamental pathos of this situation, which is powerfully epitomized at the end of their final scene together: Mrs. D embraces Mr. D and briefly dances with him—a moment for them “to meet once again / to part once again” ( p. 59). But Mr. D quickly becomes confused, and the brief sense of meeting evaporates.

The Clinician-Scientist too is presented sympathetically, through emotional investments that in part drive his work. This is done in a straightforward way: his research is prompted by his mother’s dementia. While in realist terms this is improbable (the normal onset age for a parent would be unlikely to fit with the age of research choice for a child), it is a way of conveying the idea that the Clinician-Scientist is a human being whose engagement in what he does is not purely intellectual.

The web of relationships surrounding Mr. D and impinging on his care includes the Caregiver’s half-suppressed erotic attraction to the Clinician-Scientist. In a hero-worship-cum-erotic aria with exuberant coloratura (§13)—a convention of genre to express a convention of viewpoint—the Caregiver expresses the romantic myth of the godlike doctor that is a norm of popular fiction, film, and television. Though her fantasy of the Clinician-Scientist is out of line with the fundamentally communitarian nature of contemporary scientific research, he too (“trying to think the thought / that will light the sky!” [ p. 40]) also half subscribes to this myth. These are sympathetic portraits of the human frailties within which Mr. D’s medical and care needs must jostle for attention, but the music and libretto at these points should not be taken as indicating the final view of the opera as a whole: the Caregiver’s romantic extravagance is later undercut by a virtual satire of the Clinician-Scientist’s hubris.

Symptoms of Alzheimer’s disease include a falling away of language, which can involve both a need to search for words and unusual lexical choices. Though Glyn Maxwell was skeptical about aestheticizing the effects of the illness, he does make limited use of various kinds of language disorientation—confusion, unfixed reference, ambiguity—as giving rise to their own kind of poetry. Searching for a word need not be understood as purely naturalistic: “wrong” words may have a function that cannot be perceived by the patient but can be related to the condition or the context by the audience (“winter / window”; “world / whole / hall” [pp. 41–42]: a window mirror shows the bleak physical and mental reality of old age; the care home hall shows the shrunken state of Mr. D’s whole world). Unusual lexical choices may imply perceptions that are more vivid than conventional terms (“the yellow warm”; “the blue hush / hush” [ p. 48]; “folding the boy away in the book” [ p. 27]—that is, closing the photograph album). Words are also used with double applications, sometimes in keeping with the confusions of the illness. Mr. D’s “roundabout,” with red buses and “big top” ( p. 29), is both a traffic island and a fairground machine: it connects his crucial childhood memory with his present state (which began with a catastrophic experience of disorientation amid city traffic). Just as video-projected images earlier endorsed Mr. D’s view, so here they sustain the doubt about his meaning, showing at first red buses, later a girl on a merry-go-round. Mrs. D’s unspecified “it” that “started in the night / and now [is] everywhere” ( p. 28) is both falling snow and the fundamental subject, Mr. D’s illness: for Mrs. D, it too is “everywhere,” dominating everything. “I love what’s left of him / I loved the flowers / buried in the snow” ( p. 59) more obviously insists on a symbolic sense for the same image. Other statements carry plain double meaning, such as “I shall scream,” with grimly contrasted senses for Mr. D and Mrs. D ( p. 32): he will scream if he cannot hold the birthday girl’s hand; she will scream if she has to keep hearing about the birthday girl. Similarly, “At the end of the day” (pp. 46–47, p. 60) is used by a range of characters with different meanings: literal, quasiproverbial (everything considered), symbolic (at the end of life). Such play of language draws on a symptom of the illness (dysphasia) with a variety of expressive effects.

In a drama about dementia it cannot be expected that the inevitably grim subject matter will be complemented by much lightness of tone, but the libretto does find the bizarre humour that often exists in real situations of distress, and one scene approaches the conventions and effects of farce. The subject is an approved method of care with dementia, “validation”—not contradicting the patient, even when he or she expresses a delusion. In the world of actual patients and their treatment, the ways in which this is carried out present complex problems: it is easier for a detached caregiver than for an engaged relative to acquiesce in delusions. Whatever the immediate gains in terms of the patient’s ease of mind, acquiescing in delusions may involve forms of condescension that treat the patient as less than fully human. In The Lion’s Face this treatment is subjected to the test of how it works out in particular imagined situations. Its power to heal is brought out when the Caregiver’s Daughter, explicitly acting on the idea (“I have to make believe / just like they told me to!” [ p. 61]), accepts and plays out the role that Mr. D assigns her in his fantasy. But the opera also offers what amounts to a satirical critique of how validation turns out in a different context; the principle provides an opportunity for lightening the tone with an extended scene of comedy. Since the Caregiver’s Daughter’s presence in the care home is illicit, she must be kept out of sight, and in a moment of desperation the Caregiver hides her in a cupboard. Mr. D, who knows she is there, incorporates her into his birthday party hide-and-seek fantasy: in the cupboard she is “behind the tree” ( p. 54). Overruling contradiction, the Clinician-Scientist insists that what he supposes is Mr. D’s delusion be humored. In a classic scenario of farce, he both opens the cupboard door (apparent moment of discovery) and, convinced that the cupboard is empty, looks towards Mr. D as he demonstrates his point about cooperation with the patient (discovery aborted, though the Daughter is revealed to Mr. D and the audience). The approach to this farcical climax is wonderfully heightened by the music, including elaborately extended squawks of denial from the three women (“There is no-one there, there is no-one there” [ p. 56]). In effect, Mr. D’s fundamentally accurate sense of the world around him at this point is taken by the Clinician-Scientist as evidence of delusion—a context in which his validation pieties about understanding and honoring the patient can scarcely be seen as other than ironic. As a complement to the general darkness of effect, the scene is delightfully funny.

The musical and dramatic power of The Lion’s Face are epitomized by the final scene, which is particularly moving in finding a resolution that does not sentimentalize or evade pain. The sadness of the unresolved situation for Mr. D, and the moments of resolution shared between Mr. D and Mrs. D and between Mr. D and the Caregiver’s Daughter, are complemented by the longer perspective suggested throughout by the boys: the past was what it was; there has been a life; and though the sadness of its end for the individual cannot be transcended, the music of the boys, with which the opera begins and with which it ends, is acceptingly calm. The final appearance of one boy onstage as an alter ego for Mr. D, taking over the melody he hums of the Daughter’s second song (§22, §39), unites the temporary resolutions for Mr. D with the presence of new life—even as a final breaking down of language into pure sound (wordless vowels from the boy) also points toward a new stage of mental degeneration. Suffering is not turned readily into beauty, but it does, without evasion, achieve a convincing musical and dramatic resolution.

Biography

David Fuller is emeritus professor of English in the University of Durham, UK. From 2002 to 2007 he was also the university’s public orator. He is the author of Blake’s Heroic Argument (1988), James Joyce’s ‘Ulysses’ (1992), Signs of Grace (with David Brown, 1995), and essays on a range of poetry, drama, and novels from medieval to modern. He is the editor of Tamburlaine the Great (1998), for the Clarendon Press complete works of Marlowe, of William Blake: Selected Poetry and Prose in the series Longman Annotated Texts (2000), and coeditor (with Patricia Waugh) of The Arts and Sciences of Criticism (1999). His edition (with Corinne Saunders) of the medieval poem Pearl, modernised by Victor Watts, was published by Enitharmon in 2005. He trained as a musicologist, and has written on opera and ballet. His The Life in the Sonnets was published in 2011 in the Continuum series Shakespeare Now!.