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Deny it if you want chaps but, as we age, the need to carp on about the minutiae of design and function (especially regarding bikes, see The Endocrinologist, passim) becomes ever more urgent. Partners and off spring may mistakenly dismiss this phenomenon as ‘becoming boring’ or ‘turning into your dad’. I prefer to think of it as a something of a second childhood, with great pleasure to be had in rediscovering the beauty of high functionality and cracking solutions to age old problems.

One such problem that has faced humankind since the first days of cave dwelling is how to keep the rain out but let the light in. You may have given this little thought of late, but take a minute to look around your house or office to see the various attempts to address this.

Having just finished rehanging one in an upstairs room, I am currently of a mind that one of the most satisfying solutions to the window problem is the double hung, boxed, vertical sash. When I had finished the job, I had to assemble the family to watch me open it. Then shut it. Then open it again and let some rain in. Child 2 (with headphones) looked at me in silence before shuffling off , muttering something about why we cannot get builders in like normal people.

Ask me about windows at your peril. Be prepared to engage in earnest conversation around mullions and parting beading, on the thermal physics that mean opening both top and bottom sash allows hot air to escape and cool air to be drawn in, about the beauty that is the Venetian tripartite.

So what, and who cares? Well anything that can combine seamlessly blending in with being so fi t for purpose is worthy of further thought. Sash windows do what they do so well that they are often taken for granted. But their silent work ethic belies the craftsmanship and skill beneath and, as such, they are rich in allegorical content.

The window now restored was made from slow grown, seasoned wood that was meant to last for over a century (and has done so). Beneath the flat white exterior is a hidden mechanism that works every time, the result of craftsmanship nurtured over generations. In return for years of loyal, unquestioning service, the deal is that every 10 years someone has to undertake a little maintenance to enable more years of untroubled service: sash cords grow worn, paint flakes from wind and sun, timbers twist and tighten. Yet, this key activity looked to be time-consuming and unappealing, and previous owners had neglected their duties.

So here is the clunking analogy, as I look around the wider clinical arena. Across the patch, I am fortunate to work with highly skilled individuals who have been doing what they do so well and for so long that a naïve observer could mistake their job to be a simple one. They’ve done a few decades and are now facing a few more. Having weathered storm after storm, a less lustrous patina and the odd squeak are inevitable. With no fatal flaw and still wholly fit for purpose, being designed properly in the first place, they are in desperate need of maintenance before more irreversible damage is done. Yet these folk are not resting easy and wonder what lies ahead, particularly as the outside environment has become more hostile.

People arrive to assess, but do they have an appreciation of what they are trying to maintain? Surface damage must surely mean deeper rot: better to rip the lot out and bang in replacements in a day. Give it a 10-year guarantee and then it’s someone else’s problem.

But hang on, that’s still too costly, so maybe just paint over the cracks and hope that there are not going to be too many heavy frosts this winter. The immediate cosmetic result is initially appealing, but provides only a short term solution for a longer term problem and runs the risk of causing major structural damage to a fragile organic system.

OK, enough already. Of course clinicians are more than cords, pulleys and timber. But I remain concerned that it is all too easy for health professionals to yomp on, in the belief that they are made of the right stuff and that is sufficient to see them through. It might for some, but others can easily falter and that would be a waste and a shame.

If we have any chance of coming through the months and years ahead unscathed and still fi t for purpose, we need to be more mindful of the need for maintenance and somehow factor this into our activities and timetables. A little genuine attention, some sanding down of roughened edges and a new coat for the winter can work wonders.

Tony Coll

Editor, The Endocrinologist