Was It Worth It? — Kerbside Consult

In late 1995, I sat down with Mosaic — the browser that had made the web legible to the rest of us — a 9600-baud modem, and a straightforward question: could I actually build one of these pages myself? It started as a personal challenge, learning HTML, working out how any of it connected. The site went up on GeoCities, which was free, because free was what existed and what the experiment called for. Nobody had asked me to build it. There was no plan behind it, no institution. That arrangement held until August 1999, when the BBC listed the haze page and a reader in Singapore arrived from that link, signed the guestbook, and suggested I get a proper URL. He was right. The page was still at its GeoCities address. I moved it, registered the domain, and started paying for hosting. I have been paying since.

I am writing this now because Vads Corner is thirty years old this October, and because starting Kerbside Consult earlier this year — the third reinvention of the same instinct — has made a question hard to avoid that I have been putting off for a while. Was any of it worth it? Not fishing for reassurance. Genuinely wondering.

The early site was modest — a collection of links, a few pages on topics I thought were underserved. Then in June 1997 an enterovirus outbreak broke out in Sarawak, and I put up a page. Then the haze came — the Indonesian fires that turned the sky across the region the colour of old newsprint — and readers wrote in asking for the same thing. I hadn't planned a haze page. I built one on 22 September 1997 because people asked, and because what the official sites were offering at the time, when they offered anything at all, was the kind of language that tells you a great deal about how a ministry sees its role and very little about what you should actually do.

The haze page got picked up. The BBC listed it. A Malaysian internet award found it. More usefully, people used it. They wrote to say so, in a guestbook that ran from November 1995, and what they wrote is still in the archive if you want to read it. A health official somewhere weighed a children's festival against an enterovirus and decided to cancel it, and wrote to say that something on this site helped them make that call. An engineer in Finland was faxing pages — faxing, in 1997 — to colleagues in Pekanbaru because there was nothing comparable available to them locally. A GP in Macau said she used the site in her clinical work. A researcher at a Canadian vaccine company said the same.

I want to be careful here. These were not consequential people writing to a consequential publication. They were individuals, scattered across a dozen countries, who had found a personal website run by one Malaysian doctor and thought it was worth saying something about. The fact that they wrote at all is what I keep coming back to. A site built on no budget, in spare hours, outside a career that was demanding enough on its own — it reached a GP in Macau, a parent in Maryland, a public health officer making a real decision. That is not nothing. I'm still not sure it's enough, but it is not nothing.

In March 1997, alongside all of this, I started writing Cybermed for Berita MMA — a monthly column for the Malaysian Medical Association's newsletter. The first piece was called “Internet for Doctors — Getting Started.” Reading it now is a strange experience: it assumes a reader who has never used MEDLINE, who isn't sure what a search engine is, who has no obvious reason to think the internet has anything to offer a working clinician. Within two years that reader had mostly ceased to exist. Within a decade the internet had become so embedded in medicine that the original premise of the column — that doctors needed to be persuaded to engage with it at all — was quaint.

The column adapted. It followed outbreaks month by month. It covered epidemiology, clinical trials, free journals, evidence appraisal. The August 1997 issue was about telemedicine — what it might become, what would need to happen for it to get there. Twenty-nine years later I wrote “Still Not in Force” for Kerbside Consult, about Malaysia's Telemedicine Act — passed in 1997, never brought into operation, still sitting there. The questions I was asking in 1997 turned out to be the right questions. I just didn't know how long the answers would take, or how unsatisfying they would be when they arrived.

Cybermed ran to seventy articles over nine years, ending in 2006. I kept the Nipah page online from 17 March 1999 — before the virus had a name, which is why the filename is still paramyxo.html. I kept the haze page, the enterovirus page, the tsunami piece filed on 31 December 2004 while the Indian Ocean was still claiming bodies. I kept them as they were written, with their period language and their dead links and their uncertainty about things that were later resolved. At the time this felt like tidiness — an unwillingness to go back and smooth over the edges. Looking at it now, I think the unsmoothed edges are the point. A page written while a virus was still unnamed tells you something about that moment that a retrospective account, however accurate, cannot recover.

The guestbooks closed in the early 2000s, not because the correspondence dried up but because spam had found the same door readers had been using, and it became easier to close it than to keep it swept. That was a loss I didn't fully register at the time. The books — six of them, running from 1995 to 2002 — were the most direct evidence I had that the site was doing what I hoped it was doing. Without them I was left with traffic numbers, which tell you that people arrived but nothing about why, or whether they found what they came for.

After 2006 the site continued more quietly. New outbreak pages when outbreaks came. Occasional updates. A rebuilt dengue page when the data had moved far enough from the 2005 original to make it misleading. The work was the same; the visibility was lower. I had a career to run — pharmaceutical medicine, regulatory affairs, vaccines, haematology-oncology, across most of Asia-Pacific — and the site was something I returned to rather than something I maintained continuously. There were years when I am sure it showed.

Kerbside Consult started in 2026 as a deliberate change of gear. Longer pieces. Every claim linked to a primary source. Corrections made in public and noted in the text. The subjects were ones the site had been circling for decades — haze, dengue, the gap between health legislation and health practice, what insurance actually covers when you most need it to cover something. I wrote them because the questions hadn't been answered and somebody ought to keep asking, and because thirty years of the archive meant I could show my working in a way that was genuinely harder to dismiss.

Whether that matters, I don't know. The information environment in 2026 is not the one that existed in 1997. There is vastly more to read, and much of it is produced faster and distributed more widely than anything a single writer can manage. The case for long-form, sourced, independently funded commentary is not self-evident in a world where the algorithm decides what most people see, and where the algorithm has no particular interest in careful qualification or the distinction between a primary source and a summary of a summary.

So: was it worth it?

The guestbooks say yes. The health official who cancelled the festival, the engineer in Finland with his fax machine, the GP in Macau — they say yes, or said it once, in 1999, which I am choosing to count. The Nipah page says yes, in the specific sense that a document written before anyone knew what they were dealing with is now part of the historical record of how that outbreak entered public consciousness, and that record would be thinner without it.

What I can't tell you is whether Kerbside Consult will earn the same verdict. The pieces I've written this year ask questions that will take years to answer — whether MediAsas works as designed, whether the Telemedicine Act ever comes into force, whether medical inflation responds to any of the interventions being proposed. I'll be writing, if I'm writing at all, when some of those answers arrive. Whether anyone will be reading is less predictable.

I find I'm all right with that uncertainty. Thirty years of doing this without institutional support has a way of making you comfortable with outcomes you can't control. You put the page up. You keep the light on. You find out later, sometimes much later, whether it reached anyone.

Sometimes they write back and tell you.