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EDITOR'S CORNER: Word Battles, War and Politics

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Vincent Valentine, MD
Links Editor-in-Chief
University of Texas Medical Branch
Galveston, TX, USA

In the last issue we were dung and hung with slang. For this last issue of Volume 5 as the 34th ISHLT annual meeting approaches in San Diego with the threat of a good fight from our own illustrious Dr Roger Evans, let's transition from slang to the war of words beginning with shanghai. This military term began in the 19th century referring to drugging someone (we never do that in the ISHLT) and transporting them by sea as part of the crew to Asia. Today, shanghai means in the military to transfer forcibly or abduct or compel someone. Outside the military, we shanghai others into doing something. The military has provided us with other slang terms including the classic World War II acronyms, snafu (situation normal, all f'ed up) and fubar (f'ed up beyond all recognition), of course we never see this in our profession, do we?. However these terms allow us to stay clear of taboo or politically incorrect words. We'll come back to politics shortly. We also have: AWOL (absent without leave), POW (prisoner of war), MIA (missing in action), KIA (killed in action), DMZ (demilitarized zone), and PTSD (post-traumatic stress disorder).

With the different materials and pieces of equipment for war there are terms such as bird (aircraft of helicopters), daisy cutter (originally from a horse that didn't pick up its hooves, therefore cutting daisies, to a pitch in baseball or cricket that skims the ground and now a fragmentation bomb that clears an area), frag (any grenade), fragging (assassinating an officer by their own troops with a grenade), and rock 'n roll (to put an M16 rifle on full automatic fire). Some recent euphemisms from war have leaked into our language and even in health care. Covert, hidden, friendly fire and collateral damage are emerging as side or adverse effects. Don't forget about the possibility of collateral benefits, casualties as well as shock and awe.

The effect of early antibiotic treatment for sepsis, pneumonias and other serious infections can shock and awe not only the patient, but more importantly the pathogens seriously threatening our patients. A must read for all of us in this regard is Susan Sontag's book on Illness as Metaphor. Think about it, we kill viruses, bacteria and other microbes that invade or attack our bodies. The treatment strategies include weapons to target certain conditions or diseases and at times we treat them aggressively. We wage crusades, campaigns and war to fight or fight off disease as we plan a war on cancer and build up our defenses with shots or wipe-out other infections. Note the use of painkillers and other terms including: killer T cells, infiltrating carcinomas, armies of T cells on patrol, and our defenseless immunosuppressed population. Let's not forget the quest for the magic bullet. As a result we have patients fighting for their lives, and unfortunately we end up misusing a metaphor claiming that the patient didn't fight hard enough, really?

Are we treating a disease or fighting a battle? Roger that into the political world. It is simply a battle of words. Last year, Josef Stehlik brought the "reds" and "blues" together for a new branding of our slide sets; purple backgrounds in our ISHLT slide sets. In the United States our country remains divided into red states (republicans) and blue states (democrats). But you would think purple might mean harmony, no! actually these states are "swing states" or "battleground states." What has emerged from the past and remains with us today is a term for obstructionist activities referring to a pirate or freebooter borrowed from the Dutch, French and Spanish. The word filibuster originally referred to bands of adventurers who violated international law. It later evolved into obstructing legislation referring to the activity and not the person. Wars of words or with words arose with insults from mudslinging, to lobbyist and pork barrel. Of course, the ever popular gerrymander. An eponym from 1812 refers to Elbridge Gerry, governor of Massachusetts who redrew state's districts in favor of his party. The story goes that Gerry's home district, Essex was redrawn with a certain shape. Painter Gilbert Stuart added a head, some wings and claws to map the "lizard-like" appearance of the county. When Stuart declared to Benjamin Russell, the editor of the Boston Centinel, "that will do for a salamander." Russell retorted, "Call it a Gerrymander!"

Other political terms ranging from swing states to swing voters include soccer moms and hockey moms to the hidden agendas of hot political topics with "tax relief." This assumes a tax burden. Political terms are deliberately and carefully crafted into positive terms. Instead of those who oppose induced abortion we have those who are "pro-life" versus those who support induced abortion we have the "positive" position of "pro-choice." Another example of language control includes: gift tax as opposed to the death tax.

Of course in the ISHLT we are very clear with our words and we know we'll be joining one another in San Diego to network and sing Kumbaya without cross words or cross talk. We will be clear and brief while we steer away from the "clear and present danger." Let the games and battles begin.

Disclosure Statement: the author has no conflicts of interest to disclose.

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