the effect

the effect
Rhoda Feng

Side Effects May Vary: In Lucy Prebble’s play, love and romance collide with an experimental anti-depressant.

Paapa Essiedu as Tristan and Taylor Russell as Connie the effect. Courtesy of the National Theatre. Photo: Marc Brenner.

the effectwritten by Lucy Prebble, directed by Jamie Lloyd, the Shed, 545 West Thirtieth Street, New York, through March 31, 2024

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In 2006, Parexel, a US clinical research company, conducted a trial for an experimental treatment targeting leukemia and rheumatoid arthritis. Eight healthy men were enrolled; two received placebos and six were given the medication at a north London hospital. Shortly after the study began, those who took the drug experienced serious adverse reactions, including organ failure, which led to their hospitalization in critical condition. The incident, which caused widespread concern, raised questions about the safety and ethics of such trials.

Lucy Prebble’s the effect takes a mouth swab from the Parexel fiasco, but as a dramatization of what can go wrong in medical experiments, it could have drawn from any number of real-life disasters. “The history of medicine is only the placebo story, since we now know that almost nothing worked,” says a doctor in the play. That the character who utters this is a black woman further punches the line: the history of medicine is , after all, full of racism. The embodiment of the effect Running at the Shed’s Griffin Theater until later this month, it has been slightly updated from its original version, which opened in London in 2012, and now stars an all-black cast. But the central nervous system of the show remains essentially the same, involving two participants in a phase 1 trial for a new antidepressant that goes off the rails in a matter of weeks.

Paapa Essiedu as Tristan and Taylor Russell as Connie the effect. Courtesy of the National Theatre. Photo: Marc Brenner.

Dressed in matching white sweats, Connie (Taylor Russell) and Tristan (Paapa Essiedu) move around a runway that clearly suggests a petri dish (Soutra Gilmour designed the elegant set). They have an unsavory encounter with cups of urine; Tristan gently pokes Connie about her distress over her sample (“Why are you like that, it just came out!”) before persuading her to give it to him so he doesn’t have to make the trip to the doctor . office In fact, the cups are notional. The show is directed by Jamie Lloyd and, as with its bare bones A doll house i Cyrano de Bergeracthe stage is almost completely devoid of props.

Michele Austin as Dr. Lorna James and Taylor Russell as Connie the effect. Courtesy of the National Theatre. Photo: Marc Brenner.

The actors are moved by audience members, who sit on raised platforms, watching the action and each other across the catwalk. Bright white floor panels (Jon Clark did the lighting) illuminate the characters when they ask a doctor questions, as if to evoke parts of the brain lit up on an MRI. Over the course of four weeks, they will be given titrated doses of a drug designed to stimulate dopamine – “the rush you get when something exciting happens”. Dr. Lorna James (Michele Austin) administers the pills, records the participants’ behaviors and reports her findings to Dr. Toby Sealey (Kobna Holdbrook-Smith), an elegant psychiatrist who happens to be her former lover. At high doses, Connie and Tristan report feeling “more awake” as well as experiencing racing thoughts and increased sex drives. In other words, they exhibit all the classic symptoms of falling in love. (The effects of the medication are eerily similar to those of LuvInclyned, the fictional psychotropic specimen that can induce “deep sentimental desire” in George Saunders’ 2010 dark pharmaceutical fable “Escape from Spiderhead.”) However, Connie, rational psychology student that she is, she begins to suspect that she or Tristan are taking placebos; the thought that she doesn’t love him the way he loves her is crushing.

Kobna Holdbrook-Smith as Dr. Toby Sealey (background), Paapa Essiedu as Tristan and Taylor Russell as Connie a the effect. Courtesy of the National Theatre. Photo: Marc Brenner.

But as the doses increase further, more complications occur. The question of who could be on a placebo is displaced by a more urgent one: will the drug endanger their health? At 100 mg, the side effects are already alarming: participants are bored, suffer from intestinal problems and one of them starts to show “aggressive behavior and paranoia”. With Toby’s urging, Dr. James will eventually administer a final dose of 250 mg. Punctuating the adrenalized anticipation is George Dennis’ percussive beat, which vibrates in the chest cavity.

Michele Austin as Dr. Lorna James a the effect. Courtesy of the National Theatre. Photo: Marc Brenner.

For nearly all of the play’s hundred minutes, the doctors stand guard on opposite sides of the stage, occasionally moving to the center to explain how the brain keeps the body in homeostasis or to share something of their medical history . In one of the most poignant moments, Dr. James expresses the torment of living with depression: adopting a combative voice, she berates herself for being “lazy,” for “decaying,” for being a “coward,” for ruining her life the people. It’s hard to see, but watch us do it: her inner demons, successfully suppressed in the first half of the play, now follow her with the tenacity of a documentary film crew. Did Toby accuse her of overseeing the trial despite her history of depression, or because of it? He ended his affair a few years ago partly because of his condition; if he has his druthers, depression will one day be banished by drugs. For her part, Dr. James insists that depressed people tend to have a more accurate view of the world, and she doesn’t want to “cure” herself of anything.

The way the play’s two overlapping stories split in two is a mite diagram. And there’s a touch too much emphasis on cerebration: not just the absence of props, but gestures hinted at but never enacted (handing over a broken smartphone, sharing a newspaper, borrowing a mirror). they all encourage us to reflect on visible and invisible, manifest and latent effects. this the effect it doesn’t turn into a Cartesian musing on mind-body dualism or a sub-Stoppardian allegory on the hard problem of consciousness owes much to Russell and Essiedu’s fresh performances. Stepping into a role originated by the mighty Billie Piper would be difficult for anyone to manage, but Russell makes the play her own; she begins as a reserved woman who dispenses personal information as carefully and deliberately as a pharmacist dispensing prescription drugs, but becomes uninhibited to the point of feeling almost no remorse for what one doctor calls “bad decision-making.”

Paapa Essiedu as Tristan and Taylor Russell as Connie the effect. Courtesy of the National Theatre. Photo: Marc Brenner.

As Connie and Tristan find ways to spend time together illicitly, in each other’s rooms in a former asylum, away from the supervision of their attendants, their romance traces back to that story of young love and prohibited: Romeo and Juliet. Prebble, who has also written for HBO Successiondeftly balances aphoristic zingers (one character refers to heart surgeons as “plumbing[s] of the body”) with clear poeticisms: the antithesis of the antiseptic language of science. Speaking about the experience of falling in love, Connie says, “There’s something inside of me, but it’s like it’s coming from outside of me. Like having time inside.” the effect it has its own internal weather system: full of scattered clouds, thunder and a ray of sunshine.

Rhoda Feng is a freelance writer based in Washington, DC.

Side Effects May Vary: In Lucy Prebbles’ game, love and romance collide with an experimental anti-depressant.

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