‘The Effect’ at San Francisco Playhouse – absorbing, moving and compelling

Tristan (Joe Estlack) and Connie (Ayelet Firstenberg) get to know each other

The world of clinical testing is an interesting, but somewhat murky one to those who are not involved in the study and application of this practice – which of course means most of us. Clinical trials are held to test the effect of new drugs on human volunteers, to see whether the drugs should be approved for wider use in the general population – and this is the pivot around which the action revolves in the latest  San Francisco Playhouse production, The Effect.

Award-winning playwright Lucy Prebble was drawn to this subject following an actual clinical trial in Britain in 2006, which went horrifically wrong. The volunteers ended up in intensive care, being treated for multiple organ failure, and with heads so swollen that they resembled the Elephant Man. The Effect won a Critics Circle Award following its world premiere at the National Theatre in London in 2012, and four years later it opened at the Barrow Street Theater in New York.

Joe Estlack as Tristan, Susi Damilano as Dr Lorna James, and Ayelet Firstenberg as Connie

In this production, Connie (Ayelet Firstenberg) and Tristan (Joe Estlack) have volunteered to become human guinea-pigs in the clinical testing of a new super-antidepressant. Connie is doing so because she sporadically suffers from depression, while Joe is simply doing it for the money. Neither of them has any idea of the possible side-effects that might be caused by this drug, and initially, neither of them knows which of them is being given a placebo, or indeed, whether either of them actually is.

What they do discover, though, is that during the long hours between consultations with Dr Lorna James (Susi Damilano) who is conducting the trial, and administering the drug, they rapidly become more and more interested in each other, and before long, they fall in love. The problem, though, is that neither is sure whether this is actually what’s happening to them, or whether it’s a side effect of the drug.

Dr Lorna James (Susi Damilano) and Dr Toby Sealey (Robert Parsons) discuss the case

Things become more complicated as it transpires that Dr James and her superior, Dr Toby Sealey (Robert Parsons) are dogged by their own personal issues – and when they realize the effect that this trial is having on their two volunteers, they’re forced to examine the ethics of what they’re doing, and the responsibility that they both bear towards Connie and Joe, as their respective characters are systematically laid bare.

The Effect is an absorbing play. It’s also moving, thought provoking and compelling, with some welcome flashes of humor. Director Bill English keeps a tight rein on the production, drawing riveting performances from each member of the cast, as their characters develop.

Initially, Firstenberg is delightfully and disarmingly frank and unperturbed about the experiment – which is basically what it is – and Estlack is a bit of a character – likeable, fun, larger than life and almost nonchalant about what he’s doing. They both start off as accommodating and obedient volunteers, but as tensions rise and fear creeps in, they suffer a startling loss of control over their emotions as they give vent to their frustration and anger.

Tristan (Joe Estlack) grows concerned over Connie’s (Ayelet Firstenberg) state of mind

Susi Damilano is a professional, methodical, business-like and somewhat aloof doctor, until her emotions get the better of her, and Robert Parsons uses his bravado as a weapon to disguise an inadequacy brought on by his past – but is unable to maintain this mask when he, too, feels threatened.

The stage design is eerily sparse and – yes, clinical – with some creative use of lighting and special effects, and the minimalist sets are efficiently and briskly changed.

Whilst decidedly sobering, The Effect is also likely to spark off some fascinating discussions, particularly around the morality of clinical trials such as this, and the wisdom of giving one human being such power over your life.

The Effect runs at the San Francisco Playhouse until April 28th. For more information and tickets visit sfplayhouse.org.


All photographs by Jessica Palipoli


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