When the curtain goes up on this new adaptation of Brideshead Revisited next week, nearly one thousand well oiled, Oxbridge code-breaking minds will judge me. Yes, ‘Ye shall be judged… ye shall be judged’, the words from Luke, 6.3738, echo back at me, like the tolling of a leaden knell. I have taken perhaps one of the most fiercely well-loved novels in the English language and I have transfigured it into just under two hours of theatre. This somewhat disturbing fact has induced me to muse, as the hour draws ever closer, on what actually makes a good adaptation of a novel in the first place.

As I have mentioned before, what I have chosen to bring out in this adaptation is the tragedy of the piece. In order to present Brideshead as a modern tragedy, I have written the play so that the audience is guided through it by Charles, its narrator who – in the manner of the narrator in Tennessee Williams’ The Glass Menagerie – will constitute the link between the audience and the action and, by sharing with the audience the reflections of his future self, will create an unbearable sense of dramatic and indeed tragic irony. Through the development of this close relationship between the protagonist and the audience, I hope that the audience will be able to take away Charles’ ultimate realisation about the futility of wasting one’s life in search of an idyll that never existed. This ultimate message is not as hopeless as it initially sounds. Charles’ belated arrival at a state of self-knowledge is preferable to never coming to this realisation at all, as is tragically the case with Sebastian.

I believe that the true power of Brideshead lies in its apocalyptic depiction of human interaction, centred on the self-destructive relationships between Charles, Sebastian, Julia and indeed the entire Marchmain family. In order to achieve this absolute focus, I have also reduced the number of superfluous characters that are required to people a novel, but have no place in an intense emotional drama. Although I have retained many of Waugh’s iconic lines from the novel, I was also compelled to write a lot of new material and even some entirely new scenes, the success or failure of which will on whether or not the timbre and register of my lines is identical to Waugh’s. I certainly hope it is.

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Ultimately, Brideshead is neither a paean to decadence and velvet smoking jackets, nor a celebration of the age-old Oxonian stereotype. It is simply the tragic and moving story of a man and his search for something to fill the empty void within himself and to alleviate the harshness of reality. Although at first glance, the trailer might suggest otherwise.

The placebo effect is one of the best examples of ‘mind over matter’; we are able to affect our bodies through our beliefs. Most commonly referred to with respect to pharmaceuticals, a placebo is a simple sugar pill administered under the belief that it is a drug, which is found to have positive effects on an individual’s health. Many new drugs are sunk before reaching the market as they are no better than a sugar pill. The power of the placebo gives it use as a medicine, but some would argue that such deception is unethical. I would argue that this is not the case.

The scope of the placebo effect is wide. Sugar pills labeled as muscle relaxing drugs caused muscle relaxation, whilst the same pills labeled as stimulants induced muscle tension. When used as painkillers, placebos were found to be half as effective as aspirin and half as effective as morphine, despite morphine being a much more powerful painkiller.

A study of a valium-like drug found a yellow variant was preferable for treating depression, and a green one for anxiety.  Placebo capsules elicited stronger responses than placebo pills, whilst an injection of saline solution (with no known therapeutic effect) proved even stronger. Sham surgery, where a surgeon makes an incision and then pretends to perform an operation, was very effective, especially that involving hi-tech machinery.

To be effective, the deception involved must be well maintained. Participants under the illusion that a drug was more expensive were more responsive to its perceived effect. Branded packaging also proved more effective than bland boxes. This effect is not restricted to placebos: some people find branded, expensive ibuprofen to be more effective than supermarkets’ own brand products, only because its looks better and costs more.

The placebo effect is not limited to medicine, and can be observed in everyday life. Hotel cleaners told that cleaning hotel rooms constituted ‘good exercise’ lost weight and felt healthier. In the 19th century, patients were admitted to a local hospital with food poisoning symptoms, having been told tomatoes were poisonous. This is an example of the ‘nocebo’ effect – the reverse placebo effect.

What is the physiological basis of the placebo effect? It is unclear, but we believe that expectancy interacts with other neuronal and physiological systems. It is also suspected that association affects the patient. This was demonstrated by having patients take genuine medicine with a sweet drink, then observing the drink elicit the response of the medicine. However, research into the placebo effect is difficult:  from an ethical perspective, the researcher is deliberately withholding medicine from an ill patient.

This is the key point; many believe that lying to a patient and providing ‘fake’ medicine goes against a doctor’s role, and undermines the doctor-patient relationship. Some individuals are less susceptible to the placebo effect, and withholding proper medicine from these individuals is dangerous. As mentioned, the placebo must be dressed up and priced as genuine medicine, leading to fears that patients could be overcharged for useless, fancy looking skittles. 

However, there are cases where placebos are more useful than genuine medicine. Patients suffering from severe burns cannot be given morphine (due to respiratory problems associated with); a placebo painkiller can be of great relief. Similarly, over prescription of antibiotics can lead to drug resistant bacteria, a problem solved by prescribing placebos to less serious cases.

A placebo need not be administered dishonestly. It has been shown to work where patients were told they would receive pills ‘whose mechanism is unclear’. And whether or not the doctor is truthful to the patient, a doctor’s ultimate role is to aid recovery, and if a placebo is the most effective way of doing so, it should be considered unethical not to prescribe it.

The placebo effect demonstrates the incredible power of the mind over the body. It also asks the question as to whether it is acceptable to deceive patients for with the aim of helping them. The issue comes down to your belief in the role of the doctor; to be honest with the patient or to relieve the patients suffering. Placebos have the unqiue ability to make these two qualities mutually exclusive. 

Last week England were left humiliated by one Swissman as an unopposed Sepp Blatter walked into a fourth term as FIFA President having fended off English Football Association Chairman, David Bernstein’s impassioned call to postpone the FIFA Presidential elections. On Saturday that same embarrassment was replicated by a factor of eleven, as a dogged Switzerland dug out a credible draw against a distinctly average England team. England’s lamentable performance may not have been as laugh out loud funny as that of a Carry On film but it certainly displayed its fair share of farce – comical defending, tactical conservatism and selection queries – providing further evidence that the lessons of South Africa are still to be learnt.

First and foremost Capello’s starting XI was wrong. Whilst many point to the omission of Aston Villa winger Ashley Young, who picked up the Man of the Match award in England’s last European Qualification game against Wales and scored the crucial equalizing goal when he came on as a second half substitute on Saturday, with Manchester City midfielder James Milner playing in his place, questions should perhaps be asked about the central defensive pairing of Rio Ferdinand and John Terry, midfielder Frank Lampard’s contribution and Aston Villa striker Darren Bent. Ferdinand and Terry may be the two most experienced central defenders in English football however their lack of pace was clearly exposed by the impressive Swiss midfielders Tranquilo Barnetta (Bayer Leverkusen) and Xherdan Shaqiri (FC Basel) and striker Eren Derdiyok (Bayer Leverkusen) who provided a constant threat down both flanks and from the long ball over the top of the back four. Their communication and general marshalling of the defensive line was poor, no more so than from set pieces. Both players are, perhaps more so Ferdinand, prone to injury and perhaps the constantly impressive Phil Jagielka of Everton and Michael Dawson of Tottenham Hotspur, who demonstrate both pace and aerial ability, should be given more chances.

Indeed, pace was a key element which was missing both from the defence and in central midfield. Whilst young Jack Wilshere – one of the few bright sparks in an otherwise lackadaisical England performance – at the age of nineteen continues to impress, working tirelessly, exhibiting an abundance of creativity and a change in pace, the same cannot be said of his compatriot, Frank Lampard. There’s no doubt that Lampard in a Chelsea shirt has been consistently excellent for a number of years but you feel that his days in an England shirt are numbered. Perhaps the long season caught up with him more so than other England players however the thirty-two year old was left trailing behind the youthful exuberance of the Arsenal midfielder. He was often overpowered by his opposite number – the tall, athletic Swiss Captain Gökhan Inler, linked with a possible summer move to Arsenal. Alongside the former West Ham United midfielder, Valon Behrami, the Udinese man, was commanding, showing a good distribution of the ball to his wide men. He broke up England’s attacks well, especially in the second half, and you wonder how England would have faired with a fully fit Owen Hargreaves to fulfil that same role?

Although England undoubtedly exhibited pace going forward through the likes of Wilshere and Walcott, questions remain about Walcott. Whilst he has a natural burst of pace, I remain concerned about his ability to both deliver a killer through ball to the striker(s) and where his best position is. Predominantly used my club manager Arsène Wenger as an out an out right winger, Walcott has occasionally started up-front playing off the main striker. Unless he does find a regular position, you feel that he could well become a utility player for England. In some ways he boasts the same traits as Tottenham Hotspur winger Aaron Lennon, although Lennon’s final ball has notably improved over the season – something which Walcott must work on. If Capello was looking for delivery from the wide areas, then surely the likes of Manchester City’s Adam Johnson and Aston Villa’s Stewart Downing should have been at the forefront of the Italian’s mind. Downing would have provided the perfect foil for striker Darren Bent with the two of them having developed a good understanding during their time at Aston Villa whilst Johnson, who wasn’t even selected on the England substitute’s bench, has undoubtedly been one of the Barclays Premier League’s most consistent wingers.

Whilst England possess a wealth of midfield players, the same cannot be said of the strikers. Capello named Darren Bent as the lone striker in the 4-3-3 formation flanked either side by Walcott and Milner however Bent once again failed to seize on the opportunity to prove himself on the international stage. He may have finished as the leading English goalscorer in the Barclays Premier League Season but his performance, encapsulated by blowing a golden opportunity to win the game for England in the final quarter of the game, demonstrated both how Bent is yet to make the transition between the domestic and international stage and how badly England missed the suspended Wayne Rooney’s running power and creativity. Furthermore, Capello’s decision to select Bobby Zamora ahead of Peter Crouch, who has scored 22 goals in 42 England appearances, on the substitute’s bench was another show of conservatism and, if reports are to be believed, has prompted the Tottenham Hotspur’s striker to consider his international future. Arguably it has been Capello’s inability to find a suitable strike partner for Rooney, having tried out the likes of Bolton Wanderers’s Kevin Davies and even dropping down into the Npower Championship with Jay Bothroyd from Cardiff City which has been one of the factors which has led him to revert to a 4-3-3 formation – something which he now appears very reluctant to diverge from.

Following the abysmal showing in South Africa, calls were made for England to scrap their inflexible and outmoded 4-4-2 system and change to a more European 4-3-3 system. The change in formation which has since taken place since has bore fruits for England with the midfield three often overpowering the opposition, albeit of a lower calibre, and providing the wingers with a licence to attack and get in support of the lone striker. Nonetheless, the system has its limitations, with the principal concern being that of how to accommodate players in their chosen position? For example, with Rooney expected to be reinstated back into the starting XI, do you play him on the wing and allow him to get in support of the striker or risk playing him up-front on his own knowing that he is not suited to the role of a lone striker? Furthermore, such a system requires keeping possession with intent – something which England were poor at doing on Saturday. They have to learn to not go for the hit and hope long ball option but rather to be patient in possession and in the process wear down the opposition – something which the Swiss did do effectively.

Ottmar Hitzfeld’s team, which famously conquered World Champions Spain at last year’s World Cup, proved that they were no walkovers. They played like a team reinvigorated perhaps as a result of the retirement of some of the old guard, namely record scorer Alexander Frei and strike partner Marco Streller. And whilst doubts still remain in central defence with the Barclays Premier League pairing of Arsenal’s Johan Djourou and Fulham’s Philipe Senderos appearing unconvincing on a number of occasions, it was in midfield where the Swiss particularly impressed. Inler and Behrami, the former in particular, distributed the ball well and made full use of wingers Barnetta and Shaqiri. The young man from FC Basel, Shaqiri, making his eleventh appearance for his country caught the eye with a number of surging runs and was not afraid to test Joe Hart in the England goal. Hitzfeld acknowledges that qualification for next year’s European Championships is virtually impossible and so he has taken this opportunity to blood new players such as Shaqiri into the first team, which has already paid dividends and is something which Capello should be actively considering with the likes of Gary Cahill, Daniel Sturridge and Andy Carroll all looking to follow in the footsteps of the already established Jack Wilshere.

However, it appears that Capello is afraid to make any radical changes to his team, especially in personnel. Perhaps he feels that some of the players in his squad are simply not yet ready to progress to the next level or that the pool of talent from which he has to pick is simply not good enough. All of these are reasonable excuses however the Italian, who possesses a wealth of footballing knowledge, must acknowledge that at times he must be bold. His move to bring on Ashley Young at halftime was brought about both by the context of the game but also a realisation that his conservative approach had failed miserably and that a change of pace and energy was needed. He must also communicate to the players that they should not be afraid to make mistakes and that possession is of a paramount importance when playing the 4-3-3 system. Nonetheless, with communication between the manager and the players appearing to be an ongoing problem, that despite the Italian having three and a half years in which to get to grips with the language, you wonder whether he’ll be able to effectively communicate this message to them before England once again resume their European Qualification campaign in early September.

Capello’s men sit at the top of the group on goal difference thanks to Montenegro failing to take advantage of England’s slip up with a home draw against Bulgaria. England still remain favourites to progress from Group G and onto next year’s European Championships in Poland and Ukraine however two consecutive home draws in their European Qualification matches have made their task just that bit harder. They now face two testing away trips to Bulgaria and nearest-rivals Montenegro in September and October respectively, which will be a real test of the team’s resolve. The FA and, particularly, England fans will be hoping not to see a repeat of the events of 21^st November 2007. We all know what happened then.