The challenge with any simulation is to confuse it with the real thing. That is, to buy into the scenario, to get the heart rate up just a little, to simulate a stressful situation we want to practice responding well to. But is there a danger in confusing the real thing with exercises? In making the exercise the real thing?
In the 2022 movie, White Noise, the town has to evacuate. They arrive at the designated reunification point.
Jack Gladney (Adam Driver), pointing to the armband of the aid worker assessing his risk from exposure to the ‘toxic airborn event’, says, “What does SIMUVAC stand for?”
Aid worker: “It’s short for Simulated Evacuation, a new state program they’re battling over funds for.”
“But this evacuation isn’t simulated, it’s real.”
“Well we know that, but we thought that we could use sim as a model.”
“Are you saying you saw the chance to use the real event in order to rehearse the simulation?”
“We took it right to the streets.”
“How’s it going?”
“The insertion curve isn’t as smooth as we’d like. We don’t have our victims laid out where we’d want them if this was an actual simulation. You have to make allowances for the fact that everything you see tonight is real.”
Simulations as simulacrums
Simulacrum and simulate have the same word origin. The former, simply defined, is an image or a representation. But it has deeper connotations.
"...the simulacrum is essentially the copy of a copy, that is to say, the copy of something that is not itself an original... On this view of things, anything deemed to be an original idea or object is in fact a mirage, an optical illusion of the same order as back-projection in cinema." (Oxford Reference, simulacrum).
There is definitely a cinematic quality to simulations I have been involved in. And that isn't an indictment. In medicine and science, we work in a world of copies, models, and, even, fiction. Some (philosophers) consider models a type of fiction, since they are not something concrete, but a representation, an abstraction.
“…when Bohr introduced his model of the atom he introduced a fictional object of the same kind as the object Conan Doyle introduced when he invented Sherlock Holmes...What makes a work a fiction is not its falsity (or some ratio of false to true claims): neither is everything that is said in a novel untrue (Tolstoy’s War and Peace contains many true statements about Napoleon’s Franco-Russian War), nor does every text containing false claims qualify as fiction (false news reports are just that, they are not fictions). The defining feature of a fiction is that readers are supposed to imagine the events and characters described, not that they are false...” (Stanford Encyclopedia of Philsophy, Models of science).
That sounds about right when it comes to simulations, imagining disasters and patients, sometimes with the help of some makeup and moaning. Baudrillard is the philosopher credited with developing this deeper meaning of simulacrum,