Kerbside Consult

The guestbooks were never meant to be the point. They sat underneath the actual pages — enterovirus, haze, Nipah, West Nile, dioxin — simply as a place for readers to say something, if they wanted to. Looking back now, what they recorded was something I had not really appreciated at the time: who was using the site, why they had come, and occasionally what they did with the information they found there.

The haze page exists because of a guestbook, not the other way around. An enterovirus outbreak page went up in early 1997, and requests came in for the same treatment of the haze that year. I had a full-time job throughout all of this. The website was never my day job. I built it because there seemed to be a genuine gap in what was publicly available, and I thought I was in a position to help close it. That is the entire origin story: someone saw a gap, and someone else’s asking confirmed it was real.

It is difficult now to remember what looking for health information online meant in 1995. There was no Google. The first consumer health websites — WebMD, MedicineNet — did not exist yet either; both launched the following year. Most medical information online, where it existed at all, remained written for doctors rather than patients. A personal website explaining an outbreak in ordinary language could therefore end up travelling much further than its author ever expected.

What follows in the archive is not, for the most part, praise. It is need, stated plainly. A reader in Sangatta, East Kalimantan, wrote that here at last was information that let them make decisions about their family’s health. A reader in Kuala Lumpur, having already tried the ministry and department websites, described them as “full of official air” — and came here instead. A county health official, managing an annual international children’s festival, wrote that the site’s information on an enterovirus outbreak helped them make what they called a painful but necessary decision to cancel it. A general practitioner in Macau signed in to say she used the site in her own clinical work. A researcher at a Canadian vaccine company did the same. An engineer in Finland was faxing pages — actually faxing them, this being 1997 — to colleagues in Pekanbaru, because nothing else was available to them locally.

None of these people knew each other. A doctor in Macau, a parent in Maryland worried about coxsackievirus at a daycare, a public health officer somewhere weighing a festival against a virus, a man in Brunei — all arriving independently at the same personal website, run by one physician, because in the years before ministries and international health agencies had websites that were easy for the public to navigate, this was sometimes one of the few plain accounts they could find.

It was not all solemn. Somewhere in among the outbreak questions is a visitor who just wanted to say the site was a good effort, and another explaining, apropos of nothing, why nobody stops at one dog. Guestbooks do that. They hold the important messages and the passing ones in the same list, which is honest in its own way — most of what people say to you is not going to be profound, and the ones that are stand out precisely because of what surrounds them.

By the early 2000s, spam had found the guestbooks the same way readers had — the same openness that let a GP in Macau find the site let bots find it as well. It is the reason the books stop where they do. Not because the correspondence dried up, but because it became easier to close the door than to keep sweeping the porch.

Looking back after thirty years, I don’t think the traffic numbers are what matter. Nor does the counter that gave out after three weeks in 1997. What matters is that somebody in Macau used something I had written in clinical practice; somebody in Finland thought it worth faxing to colleagues in Indonesia; a family in Maryland found an answer they were looking for; and somewhere, a health official used the information to help make a difficult decision.

People wrote back. Thirty years later, that seems as good a measure as any of whether it was worth doing.

The record itself