The Center Cannot Hold is based on the memoire of the same title by Elyn Saks. The idea of developing the opera came to Wells after Dr. Saks served as a guest speaker for a performance of Wells’ first opera about Eleanor Roosevelt, “The First Lady,” in the Winter of 2010. “Let’s collaborate!” said Saks after the performance; “OK” said Wells, “A research grant or an opera?” “Both” Saks replied. The research grant about state variations in use of physical restraints in psychiatric hospitals was not funded; but the opera is completed.

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The opera is based on a period of hospitalization in New Haven when Dr. Saks was in law school. Several hospitalizations in different institutions with different attending physicians were consolidated into one episode to simplify the story. While largely based on the book, some scenes, particularly those about providers, are fictionalized, based in part on experiences of Wells as a medical student and psychiatry resident during roughly the same period as Saks’ New Haven hospitalizations.

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The opera uses portions of the poem “The Second Coming” by William Butler Yeats, 3 quotations from Aristotle and one from Shakespeare’s “Hamlet,” portions of the Latin Mass (Agnus Dei) and Hebrew Torah (Shema), and paraphrases and adapts portions of the first movement of Beethoven’s Fifth Symphony and the classic academic song “Gaudeamus Igitur.”

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The opera is about a significant step in the road to recovery after Saks learned early in her life that she had a severe and persistent form of mental illness, paranoid schizophrenia. Although she struggled for years with acceptance of the diagnosis and alternatively accepted and resisted medications, she eventually learned that a combination of medication and psychoanalysis coupled with the support of friends, family and colleagues, helped her maintain her coping to live a rewarding life. She has led a brilliant career and maintained a happy and loving marriage, and enjoys many friends and colleagues. The opera is not about all of those successes. This Opera, is about the first step: a turning point for a young woman facing overwhelming odds of succumbing to a devastating illness, who decides to do her best to live her life fully and ends up graduating from Yale Law School and developing lasting friendships. It is also about the struggles and challenges in dealing with severe mental illness for healthcare providers, families and patients in the early 1980’s when the opera takes place.