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Comments on Writing Letters to the Editor: Moving From Duels and Fencing to Belles Lettres FREE TO VIEW

MaryAnn Foote, PhD
Author and Funding Information

From MA Foote Associates, Westlake Village, CA.

Correspondence to: MaryAnn Foote, PhD; e-mail: fmawriter@aol.com

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).

© 2010 American College of Chest Physicians

Chest. 2010;138(1):228-230. doi:10.1378/chest.10-0570
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Letters to the editor can be useful in allowing authors of published papers and journal readers an opportunity to exchange further information, ask questions of the authors, or report conflicting data or alternative viewpoints. Some journals allow case reports as letters to the editor.

If you regularly read medical journals, you may wonder if some of the letters to the editor were written in hasty anger, which does no one—the author of the paper, the author of the letter, the journal, or science in general—any favor. I think of these letters to the editor in terms of duels and fencing. A belles lettres approach would be so much nicer.

A duel is generally defined as a type of combat between two fighters who may have different weapons at their disposal (think of any movie set in ancient Rome). A duel is generally fought to the death of one of the participants, and the duel itself may have been set up to retrieve perceived trampled honor to self, family, or clan. A duel is considered coarse and bloody, although some believe (eg, Alexander Hamilton) that duels are conducted according to a code of ethics.

Fencing, a type of duel, is generally seen as more elegant, with both parties equipped with similar weapons and nattily dressed (eg, the Three Musketeers). Brain, not brawn, as well as dexterity and patience serve the successful fencer well. A good fencing duel may end with the death of a participant, but there would be much back and forth, thinking, and planning during the encounter. Fencing duels, too, were used to settle slights and dishonors.

Belles lettres, on the other hand, means “beautiful writings,” particularly elegant writings (although a more frivolous definition also exists). Belles lettres are art, using words and ideas in aesthetically pleasing ways, and they often are thought to encompass the genres of essays, speeches, and letters. These works are not coarse, and no blood is shed during the process of persuading the reader to the writer’s point of view. Thus, while many authors take a rough stand in their letters to the editor, often in argumentative terms, it is possible and preferable to use the belles lettres approach.


Some letters to the editor make us wince and think “that went for the jugular” when we read them. Letters that may be considered duels often use such tactics as:

  • Accusatory language (eg, “It is evident that the authors are wrong in their approach…”).

  • Statements not backed up by facts or backed up by facts that are questionable (eg, “The literature clearly shows that the authors are wrong about…”).

  • Generalizations (eg, “Everyone knows that…”).

  • Self-congratulations (eg, “Had the authors done their research properly they would have known that our group…”).

Dueling letters to the editor appear to have been hastily written in a fit of pique, with an eye to settling long-gone or ongoing disputes with another scientist or group. Such letters are often rejected by the journal’s editor in chief because they do not serve a constructive purpose. The authors of such combative letters probably do not enhance their reputation with the journal or the author of the disputed paper, who is generally shown all letters sent in reply.


Letters to the editor that may be classified as fencing also may deliver a deadly skewering, but are usually more skillfully written, with verbal thrusts and parries, and leave us thinking “touché, sir.” Fencing letters to the editor may be recognized by:

  • Reiteration of good findings (eg, “We were pleased to read the recent paper on the value of drug X in the setting of lung cancer, an area that we have actively pursued…”).

  • Addition to the field of knowledge (eg, “Our research has shown different findings…” or “Our research has produced similar results with the exception of…”).

  • Suggestion of alternative conclusions (eg, “We wonder if the authors considered …”).

  • Identification of possible statistical errors or trial conduct errors (eg, “The numbers in the table do not account for all patients in the study…”).

A skillfully written letter is delightful to read, can both compliment and complement, can serve to provide valuable new information, may invite a thoughtful and clarifying response, and may correct errors in published papers.


Letters to the editor and a rebuttal from the authors of the paper are published in the same issue of the journal. Letters to the editor should have some structure, almost akin to that of a meeting abstract.1 Know the journal’s policy concerning letters to the editor in terms of word count, time frame in which to reply, inclusion of tables or graphs, and number of references.

To make your letter to the editor eligible for the belles lettres category, you may wish to begin the letter by providing the citation of the article in question. In order for readers to find their way back to the original article when they find the letter in PubMed (http://www.ncbi.nlm.nih.gov/pubmed/), it is important that the letter writer refer to, cite, and include a reference to the published paper on which the comments are being made. CHEST requires this inclusion. Some background information may be necessary before plunging into the accusations or adding further information. Ensure that your facts are correct and can be backed up by valid references.

Sometimes several letters to the editor will be submitted in response to a published paper, and the journal’s editor in chief may publish only one that best encompasses the concerns and thoughts of all submitted letters. The authors of the original work usually respond to these letters in an equally thoughtful manner.

Some journals have sections that highlight news of the biopharma and device industries. If a journal has such a section and if it allows, a letter to the editor may be an excellent vehicle by which a company or investigators may provide further information or possible clarification or correction. The belles lettres approach would be best used in this situation, even if the company believes errors were made in reporting.

A final caveat is that your skillfully written letter to the editor may not be as rigorously reviewed by the journal as an original submission would be, and your letter may not be indexed in a service such as PubMed.

Notes for Letter Writers

Before writing a letter to the editor of CHEST, consult the most recent instructions to authors, specifically Guidelines for Submitting Correspondence to CHEST (http://chestjournal.chestpubs.org/site/misc/Correspondence_guidelines.pdf). Letters in response to previously published articles should not exceed 400 words and five references; replies from authors should not exceed 400 words and five references; and announcement, general interest, and research letters should not exceed 400 words and seven references. When original research is being published as a letter, only one table or one figure may be allowed, at the discretion of CHEST. All accepted letters that discuss a recently published article are sent to the corresponding author of the original work.

Notes for Authors of Original Papers

When the author of a paper published in CHEST is notified that a letter to the editor has been received and will be published, the author should seriously consider a response. This approach allows the author to clarify or expand the data in the original publication, acknowledge possible alternative conclusions or methods, or dispute the allegations of the letter writer. The letter will be in the public domain, so the responding author will be best served by a response that is akin to a duel.

Some published papers may generate a number of letters to the editor, and CHEST may chose to publish all letters that are deemed worthy. In such a situation, the author of the original published paper is granted an increased word count to fully and accurately address the points made in all published letters. If, however, the author of the paper does not wish to respond, CHEST will publish the letters without further comment.

CHEST may receive correspondence that is forwarded to the author of the original published paper for direct and private correspondence with the inquiring writer. The correspondence is not published, but the author may wish to answer the queries as if the letter were to be published, that is, scientifically, accurately, and politely.

Letters to the editor have a valuable place in the scientific literature, and journals further science by including selected letters to the editor in response to recently published papers. A good letter to the editor has a definite structure and format, and is usually limited to fewer than 500 words. Letters to the editor in this setting should be sent within a few weeks of publication of the paper. As with any scientific discourse, care should be taken to ensure accuracy in data, clarity of thought, mention of possible limitations, and declaration of competing interests. Thus, a good letter to the editor is not a duel, but can be a sportive and fair fencing match or a belles lettres that enhances and progresses the field of interest.

Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Other contributions: Once again, I thank Susan E. Siefert, ELS, CBC, and James Yuen, AB, for their excellent comments on an early draft. Thank you, too, to Dr Richard Irwin for clarification of policy for letters to the editor for CHEST.

Foote MA. Abstracts for professional meetings: small but mighty. Chest. 2008;1345:1103-1105. [CrossRef] [PubMed]




Foote MA. Abstracts for professional meetings: small but mighty. Chest. 2008;1345:1103-1105. [CrossRef] [PubMed]
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