Cause and The Effect, at S.F. Playhouse

In Lucy Prebble's play, a scientist afflicted with depression doesn't just measure her patient’s responses from a clinical distance. Her own mental health is at stake.

In Lucy Prebble’s drama The Effect (through April 28 at S.F. Playhouse), the potential for love rests inside a small vial of pills. Connie (Ayelet Firstenberg) and Tristan (Joe Estlack) meet in the laboratory of a pharmaceutical company. Both are participating in a drug trial to earn some pocket money. They’re sequestered at the facility for a few weeks, away from their normal routines and relationships. Connie is a bright psychology student with an older boyfriend back home. Tristan is closer to her age, but he’s an aimless free spirit who initially comes across as untrustworthy. The playwright weighs their newfound attraction against the artificial conditions they find themselves in. Is it their isolation and proximity to each other or the daily release of dopamine that’s causing them to fall in love?

Dr. Lorna James (Susi Damilano) administers the study, handing out the pills to her subjects while assessing their emotional reactions brought on by the drugs. She increases the dosage under the supervision of her boss Dr. Toby Sealey (Robert Parsons). Although engaged to someone else, Dr. Sealey has a romantic history with Dr. James, which complicates their dynamic. These two couples — one older, one younger — start to mirror each other as their intimacies develop on stage. But they’re inexact, shadowy reflections. As Connie’s hormones overtake her intellect, she experiences deeper layers of confusion. If she loves her boyfriend, what is she starting to feel for Tristan? Knowing that she might have to forfeit her place in the study — fraternizing is not allowed — the tormented Connie begins to confide in Dr. James in search of relief.

Tristan (Joe Estlack) and Connie (Ayelet Firstenberg) in Lucy Prebble’s “The Effect.” (Jessica Palopoli)

Prebble doesn’t make Dr. James a villain. The playwright humanizes the scientist by afflicting her with depression. She’s not just measuring the patient’s responses from a clinical distance. Her own mental health is also at stake as she continues her research for a cure. When Connie opens up to Dr. James about Tristan, she is sympathetic, offering personal, though carefully disguised anecdotes about her own experience with Dr. Sealey. To convince us of the play’s reality, The Effect relies on the audience’s belief that both couples are, or have been, in love. On the night I saw the production, the timing was off-kilter. The rhythms of the actors’ line readings were often halting, as if the four characters couldn’t find a way to connect let alone convince us that they were in love.

Despite the actors off night — and this is seldom the case — The Effect remained engaging on the strength of the playwright’s ideas, her language and a nifty set design. Prebble synthesizes scientific queries about depression and dopamine into an intelligent drama for the layperson. Her subject is the diseased brain and how it impacts the heart. Dr. Sealey’s heart may or may not be in the right place when it comes to Dr. James but the playwright gives him the ultimate prop, an actual brain that he brings to medical conventions to grab the audience’s attention. He’s a new age speaker shilling the company’s products. Dr. Sealey wants to prove their efficacy to make himself look good and to turn a profit. But Dr. James is there to check him and his conscience. She conducts her study, and her ongoing affair with him, until she receives conflicted, inconclusive results.

Nina Ball, the scenic designer, infuses cool blues and greens into the atmosphere. She cleverly suggests a clinical environment with a couple of gurneys and several monitors that line the stage to broadcast Connie’s and Tristan’s vital statistics. This is an austere vision of digitized medicine in the 21st century that looks and feels preordained. Nameless nurses hook the patients up to machines that investigate and then analyze our interior anomalies. That’s what Prebble herself is doing, investigating and analyzing the mind’s tumult, until the curious ending. She gives one of the characters amnesia. In a certain light, that plot line, borrowed from a soap opera, is the final test of love outside of the drug trial. But after all the psychological somersaults, to turn one of her creations into a blank slate felt like a negation of and an easy way out of resolving the original problems she’d asked the audience to explore.

The Effect, through April 28, at S.F. Playhouse, 450 Post St. $30-$100; 415-677-9596 or

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