Living In Sim: Justine Cooper's medical mannequin soap opera art

Heather Sparks writes for and about the medical industry. She has contributed to Wired, Popular Science, and many other publications.

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Justine Cooper is a multi-disciplinary artist living in Brooklyn whose work lies at the intersection of science, medicine, art, and commerce. Following up on HAVIDOL, a fake marketing campaign for an imaginary drug, Cooper has launched Living In Sim. This latest online and offline work presents the real and imaginary lives of medical mannequins via blog, video soap opera, installation, and photography. Living In Sim opens today, October 22, at the Daneyal Mahmood Gallery in New York City.

HS: Most people have probably never seen one of these mannequins in the real world. Can you explain how they're used?

JC: Medical mannequins serve as simulated patients in hospitals, universities, and clinics. Typically there is a two-room setup: one is where the simulation takes place, the second is where people direct the simulation and where everything is recorded.

Software controls the mannequin's vital signs according to a script. While the simulation has a plotline, it can branch off depending on how the clinicians respond and what the learning goals may be.

The whole thing can seem like improv theater or like a dress rehearsal for the real performance. The simulation finds out how the clinicians will handle everyone's needs. It can be very gripping.
The Center for Medical Simulation (in Cambridge, MA) where I had a residency this past year is very advanced in their use of simulation. They stage cases that probe the limits of human and medical communication.


HS: What is it about the mannequins intrigued you in the first place?

JC: I was introduced to them in Queensland, Australia four or five years ago. I work like a dung beetle; that first meeting was just a particle that got rolled along, growing and picking up ideas along the way. I started with their portraits in my last show, Terminal, but I wanted to turn their situation around and make them something more than the passive recipients of endless crises. So I made them the doctors and nurses–in fact, the whole hospital staff–and gave them a voice on the Web.

HS: What do you mean when you describe Living in Sim as a "mixed reality" artwork?
JC: Living in Sim is like our lives right now–where online and real-world realities are so intertwined. So much of what we do now is a hybrid. Online communication has real world ramifications, and so do medical simulations, which rely on the suspension of reality to actively seek improvements in healthcare.

HS: To that end, how would you rate the level of "realness" of the mannequins compared to our Internet- and media-saturated lives?

JC: Both are equal in that both impact our "real" lives. The mannequins help reduce the number of accidental deaths and medical error. But by giving these mannequins a voice on their blog [lead writer is Jason Lindner], and allowing them to act out their dramas in their soap opera, they're more real, and more like us, than ever.

HS: In the soap opera piece, Indemnity General, a patient's insurance takes his wife in exchange for his medical treatment. Why did you choose to play out such an outlandish drama?

JC: I really wanted to express how absurd the health industry is now. Hospitals are basically run by insurance companies like medieval fiefdoms. No, they do not take your wife as payment for services rendered, but they can be responsible for you losing your home. In fact, three-quarters of the people who are bankrupted by medical bills actually had insurance when they got sick.

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But the absurdity of Living in Sim is also intended to be playful and engaging. I'm interested in finding out if discussions about health care or medicine can be humorous. There's been so much serious debate and depressing rhetoric, is it possible to have a forum that leaves you smiling and not suicidal about the state of affairs?

HS: There are so few actual humans in Living in Sim but instead features all this technology intended to ensure human life. Let's talk about that contradiction.

JC: I think it's telling that even the small bit of humanness that the mannequins have is enough to make people engage with them very seriously in medical simulations. It's also telling that we're so surrounding by technology in our healthcare system that people insist on using it most of the time. Your knee hurts for a while and you insist on an MRI, not physical therapy. Technology shouldn't negate common sense in healthcare, but it often does.

HS: You also have taken several photos of the mannequins with religious and classical symbolism in them. Why did you decide to include these?

JC: It's meant, in a way, to reference how in our Internet-mediated social lives, we see the same images over and over. Religious and classical symbolism is a kind of imagery that we're also socially familiar with. Throughout history we see these religious paintings with the same symbolism: the saints pointing their index and middle fingers upward, the single bare breast. They're images that you see over and over. We still use the bunny sign, but we're no longer saints–we're happier than ever to show off those fleshy parts. 

Living In Sim