Words matter. The choice of words conveys meaning. As physicians and educators, we bristle — and usually respond — when colleagues or students refer to our patients as “clinical material.”
The people for whom we care are just that, people, human beings, individuals. They are not simply “material,” clinical or otherwise. Likewise, thoughtful observers question using the term “collateral damage” to refer to people. People who are injured or killed as the result of an attack not specifically directed at them are not “damage.”
Whether that is the intent or not, using the term “collateral damage” is a way of reducing tragedies experienced by individual human beings to depersonalized catchphrases.
So it is with the term “boots on the ground.”
This seemingly unproblematic way of referring to troop deployment is ubiquitous in today’s discussions of military planning. We think this phrase needs to be abandoned.
Why? Because those metaphorical “boots on the ground” are not boots. “Boots on the ground” refers to the wearers of those boots. And those wearers are actual human beings, brave men and women who risk their lives in service to their country abroad.
Some will die there. Some will return home injured; many will receive care at VA facilities.
These people have lives, friends, loved ones, and all too often dreams lost and hopes abandoned on account of what happened to them.
“Boots on the ground” implicitly invites the reader to think not about the many individuals who serve, but instead to reduce those people to a single article of clothing, one that in its uniformity belies the many different types of people who wear those boots.
Recently, one of us had the great privilege of caring for two patients in their 90s at the VA Ann Arbor Medical Center.
Both served in the U.S. Army during World War II, and both played a small but important role in saving the world from totalitarianism. Fortunately, each survived that war.
The VA staff and medical students were grateful for their service and honored their contributions by providing them with the type of superb veteran-centric medical care they deserve. During the time that we cared for these two gentlemen, we had many extended conversations with them and their family members. Those discussions taught us a great deal about the world of over a half-century ago. These two were once young men who traveled thousands of miles from home to face an uncertain future during a global conflict. They experienced a world that we have not, and we tried to learn from them.
Perhaps unsurprisingly, during all of the time we spent together, the footwear that they wore during deployment was not even contemplated. These two World War II veterans served their country heroically. We didn’t call them “boots on the ground” then, and military personnel are assuredly more than “boots on the ground” now.
We acknowledge that many who refer to “boots on the ground” do so simply because the phrase has a nice cadence. Many doubtless use the phrase without any ill will toward or desire to dehumanize the people to whom they refer.
Regardless of intent, it is demeaning to refer to people in the military as “boots on the ground,” and the use of this term should stop.
Dr. Joel Howell is the Victor Vaughan Professor of the History of Medicine and professor of internal medicine, history, and health management and policy at the University of Michigan.
Dr. Sanjay Saint is the associate chief of medicine at the VA Ann Arbor Healthcare System and the George Dock Professor of Internal Medicine at the University of Michigan.