Theater: Clinical Trial

Love, science and ethics mix in ‘The Effect’

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‘The Effect,’ currently onstage at the San Francisco Playhouse, is a humorous look at a pill-popping culture. Photo by Jessica Palopoli.

Two attractive young people have been selected to take part in a clinical trial of a new (and unnamed) anti-depressant drug developed by a fictitious pharmaceutical company. Connie Hall has signed on because she’s curious about the process and has had mild episodes of depression in the past. Tristan Fray is there because the pay is enough to cover expenses on a vacation trip he is planning. Dr. Lorna James is the project manager who administers the drug and reports results to her supervisor, Dr. Toby Sealy. The trial is double blind, meaning that neither the participants nor the staff know who is given the drug and who gets a placebo. Its purpose is to test its efficacy prior to seeking governmental approval for manufacture and distribution.

That, in a nutshell, is the setup for Lucy Prebble’s The Effect, currently receiving its West Coast premiere at the San Francisco Playhouse.

From the description, one might expect that the play would be about drug-testing and the spread of medications for just about every ailment in today’s world, with maybe a dash of romance between the young volunteers who spend so much isolated time together. Turns out that Prebble has much more—or less, depending on your point of view—in mind.

Let’s begin with the scientific content. Very little about either Prebble’s script or the Playhouse’s production conforms with what we know actually takes place during human drug trials, which (in the United States) are closely regulated by the Food and Drug Administration. Nina Ball’s sleek scenic design, starkly lit by Kurt Landisman with a ceiling chain of overhead LEDs, suggests a corporate meeting room rather than a testing lab, and sound designer Theodore J.H. Hulsker’s electronic blasts of sound between scenes contribute to the sense of unreality.

Then there is the issue of a two-person “trial.” What could possibly be learned from observing only two individuals, neither of whom has a history of clinical depression? Why would they be left alone with each other for such lengthy periods? Is it appropriate for the trial manager to interact with them on a personal basis, even sharing information about who is getting the placebo? And, finally, are the catastrophic events near the end of the play credible? (A statement included in the Playhouse press kit from Mavi Walther, recruitment and screening manager at the U.K.’s Hammersmith Medicines Research, says she’s never seen anything like the events on the stage in her 12 years on the job.)

Questions, questions.

OK, I get it. Theater is theater, not reality. You’re supposed to suspend your disbelief. Once I do that, things for Prebble and the Playhouse become distinctly sunnier. Under Bill English’s sensitive direction, the romance between Connie (Ayelet Firstenberg) and Tristan (Joe Estlack) develops gradually, allowing us to appreciate their divergent personalities and to care about them when disaster strikes. He’s an impulsive vagabond who’s quick to fall in love; she’s more reticent, but when she makes up her mind, watch out! Both actors handle these roles superbly.

The relationship between the two doctors, Lorna (Susi Damilano) and Toby (Robert Parsons) is more problematic. It seems that they once had an affair and now are finding that the embers have not yet been extinguished. That makes the atmosphere rather tense as they are called upon to reconcile their divergent views as to how the trial should be conducted. Here the script becomes a bit melodramatic, especially at its abrupt conclusion, but Damilano and Parsons—both talented theatrical veterans—manage to generate considerable sympathy for what appears to be a lost cause.

Looking over reviews of other productions of The Effect, I found that the critics almost universally ignored questions about its scientific accuracy, preferring instead to concentrate on whether what we call love is an emotional response that can be manipulated by brain-altering drugs. It’s an interesting and sexy issue—one that George Orwell dealt with beautifully in his novel Brave New World. I’d say we’re at least halfway there and running hard.

NOW PLAYING: The Effect runs through April 28 at the San Francisco Playhouse, 450 Post St., San Francisco; 415/677-9596; sfplayhouse.org.  

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