World premieres played a major part in Graham's career: he directed 55 of them — more than any other contemporary opera director, according to a spokesperson quoted in the St. Louis Post-Dispatch. In addition to the Britten works, he staged the first productions of, among others, John Corigliano's The Ghosts of Versailles (Metropolitan Opera), Andr_ Previn's A Streetcar Named Desire (San Francisco Opera), Stephen Paulus's The Postman Always Rings Twice (Opera Theatre of St. Louis), Minoru Miki's The Tale of Genji (OTSL), and Bright Sheng's Madame Mao (Santa Fe Opera). Graham wrote the librettos for a number of operas as well, including the Paulus, Miki and Sheng works. When Graham died, he was at work on his last world premiere, of David Carlson's Anna Karenina for Florida Grand Opera: he had completed the libretto and was slated to direct, though he recently passed on the latter job to his assistant, Mark Streshinsky.
Following Graham's work in the 1950s with the English Opera Group, he was a freelance director of opera, musicals and spoken theater who worked at Sadler's Wells/English National Opera, the Royal Opera House (Covent Garden), the Old Vic, and on London's West End as well as at Britten's Aldeburgh Festival. He spent several months as director of productions at English National Opera before moving to St. Louis in 1978 to become director of productions at the city's new opera company. He eventually took U.S. citizenship and made his home in St. Louis for the rest of his life.
Graham became artistic director of OTSL in 1985, and since then the company has garnered considerable renown for its four-week late spring season, in particular for its productions of lesser-known Baroque and Classical operas and American works. The company also did plenty of Britten, of course; Graham's widely acclaimed 2005 staging of Gloriana starring Christine Brewer as Elizabeth I went a long way toward moving her from being an admired concert singer to being a genuine opera star.
His career as freelance director was very active, including productions at (among others), the Metropolitan Opera, Lyric Opera of Chicago, Washington Opera, San Francisco Opera, New York City Opera and Santa Fe Opera.
According to the Post-Dispatch, Graham took up bodybuilding at age 60, ultimately entering competitions and winning championships in his age group.
According to Graham's wishes, no funeral will be held, according to OTSL, though a memorial service and concert (for which his wishes were apparently) is tentatively planned for June, with Brewer as honorary chair. The company has no immediate plans to search for a successor.