In “The Effect,” at San Francisco Playhouse through April 28, a clinical drug trial goes off the rails when two test subjects fall in love, and two supervising psychiatrists revisit an old affair.
The story plays out over a few weeks in a lab belonging to the fictional Rauschen pharmaceutical company. Two young trial volunteers, Connie Hall and Tristan Frey (Ayelet Firstenberg and Joe Estlack, respectively) have signed up to test an experimental antidepressant, ostensibly because they need the money, although that is never made explicit.
Lead researcher Dr. Toby Sealey (Robert Parsons) has great hopes for the potential of this new drug to raise levels of dopamine, a substance naturally present in the brain, but depleted in depressed people. His one-time lover Dr. Lorna James (Susi Damilano) is directly in charge of administering incrementally increasing doses to her subjects and monitoring their behavior. She tries vainly to intervene when Connie and Tristan get involved with each other, because love’s pleasure also raises dopamine levels, potentially masking the effect of the drug. She also tries vainly to suppress lingering feelings for Dr. Sealey, a man she dismisses as “the most notorious fuck-around on the conference circuit.”
Playwright Lucy Prebble’s fascinating script examines the nature of love and mental illness, calls into question scientific objectivity, and makes a deserving target of pharmaceuticals with marginal benefits and many deadly side effects. Dr. James does likewise – she remarks to Dr. Sealey that “the history of medicine is the history of placebos” and later predicts that “one day we will look back on all this chemical-imbalance stuff like the four humors.” Their relationship does not blossom anew. It’s implied that Dr. Sealey may enjoy a big payout if the trial’s results are positive.
Set designer Nina Ball is at her best here, evoking the vaguely pleasant but impersonal nature of corporate environments, with superb help from projections designer Theodore J.H. Hulsker, whose video graphics are chillingly effective.
Director Bill English gets a powerful performance from his cast of four. The show’s dark trajectory is interrupted here and there by moments of near-comedy, but the light at the end of its tunnel doesn’t shine on Dr. James. “The Effect” is a well-done theatrical rarity that entertains, informs, and provokes in equal measure.
ASR Senior Editor Barry Willis is a member of the American Theatre Critics Association and president of the SF Bay Area Theatre Critics Circle.
“The Effect” by Lucy Prebble
Through April 28
San Francisco Playhouse
450 Post Street, San Francisco
Tickets: $25 – $100
Rating: Four out of Five Stars
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