A paper may be returned to the corresponding author for no other reason than that it suffers due to poor English. Papers must be understandable and communicate an unambiguous message. The editors and staff can make only a limited number of edits, and it is the responsibility of the authors to obtain help from a colleague who is fluent in English if that is needed. Most problems occur when there are nuances in meaning, and the authors bear the primary responsibility for clarity. Poor English may ultimately be a reason to refuse a paper.