Concerns have recently been raised that AI-assisted "letter-bombing" may distort medical publishing. Although I share these concerns, prolific Letter writing can arise for legitimate reasons. Using my own publication history as an example, I illustrate how retirement, loss of access to primary data, and broader academic interests naturally shifted my publications from original articles toward Letters. The problem lies not in writing many Letters, but in inappropriate motivations and misuse of AI.
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Shigeki Matsubara (2026) studied this question.
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