“Do not go gentle into that good night…”

But maybe, finally, I can.

Tapi bila masuk bab project management, handle people, review kerja orang, reply emails, attend meetings—rasa macam tiga jam pun dah cukup untuk drain mental dan social energy aku. Most of the time, bukan kerja teknikal yang memenatkan, tapi its dealing with people. Bukan sebab aku tak suka orang (maybe juga kot, the introvert in me), tapi because switching context from deep focus to human interactions and back, its draining too much energy that what I expected.

The Reality of Climbing the Ladder

Aku bukan sorang je yang rasa macam ni. Banyak programmer yang bila mula kerja, they love the craft—writing code, solving problems. Tapi bila naik level, suddenly kerja dah bukan lagi tentang coding semata-mata. Ada expectation untuk manage projects, team, stakeholder. Some people thrive in this environment. Some, macam aku, rasa nak tekan rewind dan balik ke session coding tanpa gangguan.

Seorang programmer pernah cakap kat aku, “Kalau kau nak naik pangkat, nak better salary, at some point kau kena deal dengan people.” Tak boleh lari. Unless kau decide nak stay as an individual contributor, which usually means slower career progression, atau kau jump ke kerja lain yang lebih fit dengan apa yang kau suka buat.

Demoted but Happy?

Ada juga yang ambil langkah lain—demote diri sendiri. Maintain paygrade, tapi kurangkan beban management. Tak perlu masuk meeting yang tak perlu, tak payah pening kepala nak buat stakeholder happy. Balik kepada passion asal—coding.

Bila aku baca cerita orang-orang yang buat macam ni, ada yang nampak chill dengan keputusan diorang. Tapi dalam masa yang sama, diorang pun sedar yang rasa ‘tak sama macam dulu’. Coding is still fun, but it’s not like the early days, when everything felt fresh and exciting.

Maybe it’s part of growing up in this industry. Passion evolves. Ada yang jump into management and love it. Ada yang stay in coding and still find joy. Ada yang halfway in between—enjoy both worlds.

Balancing Focus and Work Demands

One of the biggest struggles is focus. Coding requires deep work. It’s not something yang boleh buat sambil multitasking. Tapi bila kerja dah melibatkan banyak aspek lain—meetings, emails, urgent updates—nak masuk balik dalam deep focus mode lepas semua distractions tu sangatlah susah.

Aku rasa inilah sebab kenapa ramai programmer rindu zaman belajar dulu, atau zaman awal career—masa boleh fokus tanpa gangguan. It’s that flow state yang susah nak dapat balik bila dah ada banyak tanggungjawab lain.

So, what’s the solution? Untuk aku sekarang, masih dalam dilema. Nak embrace project management ke, nak cari jalan supaya boleh balance coding dengan leadership responsibilities ke, atau nak step back dan kembali ke pure coding role?

Atau mungkin solution terbaik adalah… masuk hackathon, escape dari realiti kejap, dan enjoy the pure joy of coding macam dulu.

On February 13th, there was an MOU signing event between Angsana Health and KPJ Healthcare Berhad, intended to adopt and pilot Melati in selected KPJ hospitals this year.

Melati is an AI product that I have been building with Angsana since I joined them last year. It functions as a chatbot interface for patients waiting to be seen by their doctors. Its task is to take the patient’s history and present it as a dashboard for the doctors inside.

It summarizes extracted symptoms, generates differential diagnoses along with their positive and negative predictors, and offers recommendations on what the doctor should ask or do.

Technically speaking, its functionality is quite straightforward. However, the true strength of Melati lies in its back end—the algorithmic component. It doesn’t merely ask a set of predetermined questions, fill out forms, or tick off checkboxes.

What Melati does is that for every answer or symptom given by the patient, it actually thinks ahead. Under the hood, Melati generates a set of differential diagnoses at every stage of the chat, then decides on the next question to ask based on those diagnoses.

I designed it to mimic the thought process a doctor would have upon seeing patients in their consultation room. A doctor, especially a primary care practitioner, typically starts by identifying the chief complaint and the presenting symptoms. From there, the doctor probes further to refine the symptoms—asking for more specific or subtle details—while simultaneously evaluating their severity to decide whether the case requires referral or can be managed in-house.

Mimicking that flow of thought is a challenge, as each doctor possesses a very individual style of history taking. It is essentially an art form in itself. A doctor’s experience shapes their confidence, and the ability to tailor their approach to each patient makes history taking a dynamic and nuanced process.

I’m designing Melati to help doctors streamline this process. While taking history, Melati also screens and “triages” the patient by detecting any life-threatening symptoms. This is something I learned from my experiences working as a freelance GP. GPs rarely perform triage for their patients, and I often ended up with potentially critical cases—such as asthma attacks or chest pain—queuing in the waiting area. I’ve even had patients die because of this.

But I admit, at the practical and workflow level, Melati might face resistance or reluctance from doctors. Knowing how doctors are, they tend to find it hard to trust an external factor. A doctor generally wants to be in control—they want to take their own history, conduct their own examinations, perform their own differential diagnoses, and so on. Hence, I make it a point that Melati serves as an assistant to the doctor—not to replace their tasks, and certainly not to dictate orders or instructions.

Anyway, I spent around three months building the MVP for Melati. At that stage, it was pretty rudimentary. Then, last month, we had the prototype ready for demos to potential clients.

I think I’ve had the chance to demo it to around five or six clients already, one of which was KPJ. KPJ was looking to venture into the AI-hyped market this year, exploring AI solutions that could be integrated into their existing workflow. Suffice to say, I had the opportunity to demo Melati to their top echelons, and they really took a liking to it.

The rest, as they say, is history. Coincidentally, the MOU signing took place on February 13th in Menara KPJ. The last time I was there was during Covid. I remembered that Covid was just beginning that year, and we—the Medical Officer in Charge and the Chief Medical Officer—were summoned to Menara KPJ for a briefing and discussion about the Covid protocols we needed to implement.

It’s funny how life manages to come full circle. That year, I attended as the Medical Officer in Charge. A year later, I resigned from KPJ Hospital and started my own café business. Then I shut down my café and moved to KL to begin programming. After that, I joined Angsana Health, where I built AI applications for them—and then there I was, five years later, signing an MOU with KPJ Healthcare for Melati.

So, how do I feel about the MOU signing? Honestly, it’s been a cascade of emotions—a blend of pride, self-doubt, and deep reflection. I can’t ignore the internal voices, especially one persistent “impostor” that has been with me ever since I embraced full-time programming. I think this Impostor is worthy of its own name. I already coexist with the Dark Passenger, those voices I’ve learned to manage with diplomacy, yet this impostor roars even louder, questioning every decision I make.

At times, I remind myself that I am, first and foremost, a doctor—not merely a programmer. However, programming has been a quiet passion of mine since high school. I still recall the thrill when my project, eMas, won the Tunas Saintis MRSM Se-Malaysia competition and was selected for the Intel ISEF. Those moments felt monumental, even if they were just the beginning.

Then, last year, when I transitioned into full-time programming, I found myself thrust back into the spotlight by discovering the Malaysia PADU Database vulnerability. Such experiences force you to confront your limitations, but they also reveal your potential.

During the MOU event, a colleague confided in me. He admitted that he wasn’t entirely sure what he wanted to do with his life—despite enjoying his current role. He was , yet he still questioned if that was enough. I couldn’t help but reminisce about my own journey. At 28, I was emerging as a senior medical officer in a general hospital—handling cardiology cases, emergencies, and earning the trust of specialists and colleagues alike. It was the pinnacle of my career in the government sector.

But look at me now—stepping away from clinical practice to immerse myself in programming at 37. I told him how proud I was of his willingness to question his path, even amidst uncertainty. Walaupun aku baru menceburkan diri dalam programming di usia 37, aku percaya perjalanan aku masih panjang dan penuh kemungkinan. I sometimes wonder, if I had ventured into this field a decade earlier, what heights I might have reached. Yet every challenge and every detour has enriched my journey.

That relentless inner critic still speaks loudly, but perhaps it isn’t just a voice of doubt—it’s also a reminder of how far I’ve come. Melati remains a work in progress, a humble MVP destined to evolve. It’s not my masterpiece yet, but it stands as a testament to my resilience and capability. Despite its current imperfections, Melati reflects my journey, my growth, and my unyielding hunger for more.

“Aku tak kosong, bro.” I’ve made it this far, against all odds, and my appetite for what’s next remains insatiable.

Back in my locum days, I had the experience of working at an old-school GP clinic where they had their own way of doing things, shaped by decades of practice. One of the more memorable practices involved carrying two different syrup paracetamols—one orange, one strawberry. The approach was simple: tell parents to give the orange one first, and if the fever persisted, give the strawberry one after six hours. Then alternate every six hours.

At a glance, this might seem reasonable. Parents felt reassured that they were doing something proactive, that they had a structured system in place. But in reality, both syrups contained the exact same thing—paracetamol, just with different flavors. The parents, however, believed they were giving two separate medications with different effects.

It’s easy to judge this practice with modern ethical standards, but in context, these GPs were simply continuing what had worked for them for years. The reality is that many older clinics operated on a model of medicine that was built more on patient expectations than strict pharmacological principles. They weren’t necessarily trying to deceive; they were running their practice in a way that kept patients coming back, trusting the system that had served them for decades. And in a way, it worked—patients kept returning, convinced that their ubat lebih kuat, lebih cepat lega.

The Stigma of “No Medication”

Here’s a universal truth in primary care—patients equate getting medication with getting treated. They don’t see consultation as the main service. To them, a doctor’s role is to diagnose, prescribe, and send them off with tangible proof of treatment, preferably in the form of a plastic bag filled with colorful pills. Anything less feels like a waste of time and money.

So imagine their reaction when they walk into a clinic, pay a consultation fee, and the doctor says, “No meds needed, just rest and hydrate.” Immediately, there’s that sense of disappointment, frustration, even suspicion.

Not surprising when they respond with:

• “Doktor ni malas betul, tak bagi ubat!”
• “Habis, nak biar anak saya macam ni je?”
• “Saya dah pergi klinik pagi tadi, doktor bagi ubat demam. Tapi lepas 6 jam suhu naik balik!”

There is a fundamental misunderstanding of how fever medication works. Some parents expect one dose to magically “cure” the fever, not realizing that it’s meant to manage symptoms, not eradicate the underlying cause instantly. The fever will still cycle up and down as the immune system fights the infection, and as long as it stays within a safe range, it’s actually a good sign that the body is doing its job.

Try explaining this to a distressed parent, though. It doesn’t always go well. Many still insist, “Habis, takkan macam tu je? Bagi la ubat yang lebih kuat.” Seolah-olah ada Panadol Ultra Pro Max yang hanya hospital boleh bagi. Bila kita cakap yang paracetamol memang fever medication paling efektif dan paling selamat, tengok muka dorang—muka tak puas hati, seolah-olah kita sengaja nak bagi anak dorang suffer.

And of course, the classic complaint—“Bayar mahal-mahal, ubat pun tak dapat.” It doesn’t matter if the consultation covered a thorough examination and professional advice. If there’s no medication in hand, they feel cheated.

Why Old GP Clinics Could Get Away With It

A decade ago, things were different. Many clinics operated in a gray area—repacking medications was a norm. They could cut costs, avoid brand comparisons, and maintain business secrets that kept patients loyal.

Back then, patients had little knowledge about what they were given. No printed labels with active ingredients. No Google to compare brands or pricing. They simply trusted their doctor. When the doctor said, “Ini ubat special klinik kami,” they nodded and swallowed the pills without question. That’s how these clinics thrived.

Fast forward to today, and everything has changed. Regulations are tighter. Every medication needs proper labeling. Patients now Google every drug, check prices at pharmacies, and demand specific brands. When a doctor prescribes an alternative, sometimes even a better one, patients get upset because it’s not their usual medication.

And let’s not forget consultation fees. Patients still expect to pay RM30 like they did ten years ago, despite inflation, rising rent, staff salaries, and medication costs. When newer clinics charge slightly higher, complaints follow—“Klinik lama saya tak caj mahal macam ni pun.”

How Can New GPs Survive?

This is the real question, isn’t it? How does a newer GP clinic establish itself and gain patient trust when the playing field seems stacked against them? Lowering consultation fees to compete is a dangerous game—one that leads to burnout, unsustainable operations, and ultimately a race to the bottom.

What needs to change is patient perception, but this is not something that happens overnight. It requires consistency, education, and a balance between patient expectations and medical ethics.

Many patients expect something tangible from their consultation. If they don’t walk out with medication, they feel like they’ve wasted their money. This is where alternative strategies come in. Instead of unnecessary prescriptions, offer items that still feel like a treatment—ORS, saline spray, fever care handouts. Small things, but they satisfy that psychological need to receive something.

Then there’s the hospital factor—many patients believe hospital medications are somehow stronger. This myth needs to be dispelled with proper education. Hospitals use the exact same paracetamol and antibiotics as GP clinics. The difference is not in the medicine but in patient perception.

Pricing is another battlefield. Patients compare clinic prices and feel justified in complaining when one GP charges more than another. Here, transparency is key. If a clinic charges slightly higher, it needs to justify that cost—clearer labeling, better medication quality, longer consultations, and a more thorough explanation of treatment options. It’s not about being the cheapest; it’s about showing why the service is worth it.

Ultimately, newer clinics have to play the long game. The older clinics that patients trust today? They didn’t earn that trust overnight. It was built over years of familiarity. New clinics need to focus on retention, not just one-time visits. A patient who comes back because they feel heard and well cared for is far more valuable than a patient who only came in because the fee was RM5 cheaper.

One way for GPs to bridge this gap is through patient education via new digital platforms, including social media. While traditionally, medical advice was dispensed only within the four walls of a clinic, times have changed. A well-crafted, informative video or a simple infographic explaining common misconceptions about medications can reach far more people than a one-on-one consultation ever could. By engaging with the public through platforms they are already consuming, doctors can slowly reshape how patients perceive primary care and treatment strategies.

The Social Media Stigma

Then there’s the modern challenge—social media. Doctors on TikTok or Instagram are often judged not by their knowledge, but by their delivery. If they’re not entertaining, not visually appealing, or not making viral-worthy content, they get ignored. Meanwhile, influencers with zero medical background rack up millions of views spreading misinformation.

However, social media is no longer just an entertainment platform—it has become a powerful tool for patient education. Many younger patients turn to online sources for health advice, whether from credible sources or not. This presents an opportunity for doctors to proactively shape public health narratives by sharing factual, digestible content that counters misinformation. A simple explainer video on fever management, or a post debunking common medical myths, can reach thousands of people—something that would be impossible in a physical clinic setting alone.

But with visibility comes scrutiny. If a doctor shares health information online, suddenly they’re accused of “cari glamour”. There is a lingering stigma that medical professionals should maintain a certain reserved persona, avoiding self-promotion or public outreach beyond the confines of their clinics. The irony is, when misinformation spreads from non-medical influencers, the public doesn’t question their credibility as harshly.

And if a doctor actually gains traction? Expect competitor sabotage—complaints of improper advertising often come not from patients, but from other clinics feeling threatened. Some regulatory bodies still have outdated views on digital engagement, enforcing restrictions that make it harder for doctors to educate without being accused of commercializing healthcare.

Despite these challenges, GPs need to find a balance. Social media should not be dismissed as a gimmick, but rather embraced as an extension of modern patient education. When used wisely, it can help bridge the gap between outdated patient perceptions and evidence-based medical practices. The key is consistency, credibility, and ensuring that content remains factual and accessible.

So, What’s the Solution?

The medical landscape is changing. Patients are changing. Doctors have to adapt—but smartly. Building trust takes time. Offering value beyond just medication matters. And ultimately, success in primary care is about relationships, not transactions.

This is why I am still reluctant to open up my own GP practice. I feel that by keeping an honest practice, it is not sustainable. The pressures of patient expectations, economic realities, and competition from those who are willing to bend ethical lines make it incredibly difficult to run a clinic that prioritizes integrity above all else. Until there is a broader shift in how patients perceive medical care and value ethical practice, the struggle remains an uphill battle.

The ubat kuat mindset isn’t going away overnight. But with patience, education, and consistency, maybe—just maybe—we can start shifting patient expectations, one visit at a time.

Recently, my professional life has undergone a significant shift. Pivoting from a career as a doctor to focus more on programming and IT work, I’ve noticed a deterioration in the quality of my locum work. This change didn’t just alter how I approach my tasks; it reshaped my interactions with people.

During consultations, I found myself becoming distant, rude, and irritable. For instance, when asking a patient a straightforward question like “Dah berapa hari demam?” I’d often feel a surge of frustration if the response wasn’t direct. Why can’t they just answer clearly? Did I not phrase the question properly? Was my voice unclear? These moments left me questioning myself and my patience.

Sofiah offered an insightful perspective: these reactions could stem from a deep-seated discomfort with the unpredictability of human behavior. Unlike programming, where I can define variables and expect consistent outputs, dealing with humans means embracing imperfections and unpredictability.

This distinction is profound. In programming, I take comfort in knowing how to craft prompts and expect precise results—a practice often referred to as prompt engineering. It’s satisfying because it feeds into my need for control, which aligns with my tendencies associated with Borderline Personality Disorder (BPD).

But is this reliance on predictability a good thing? Am I feeding a pattern that pulls me further from reality and human connection? These are questions I grapple with.

As part of my attempt to reconnect with others, I reached out to Amirul, someone I trust deeply. I asked if he could spare an hour weekly to chat over a meal. It wasn’t an easy ask—I worried about being a burden or placing undue responsibility on him. At the same time, I knew this step was necessary. Human connection requires vulnerability, and by making this effort, I hoped to practice embracing uncertainty and imperfection.

As I wait for his reply, I remind myself that rejection, if it happens, doesn’t define my effort or the worth of our relationship. What matters is that I am taking active steps to break out of the patterns that keep me isolated.

Sofiah encouraged me to remain engaged in my locum work, not as a task but as an opportunity for mindfulness and connection. It’s a chance to interact with people, practice patience, and embrace the unpredictability of human responses. She also suggested fostering more social connections outside work to see how they influence my overall quality of life.

As I reflect on this, I see both the challenges and growth opportunities. While programming offers structure, the human aspect of locum work grounds me in reality. Striking a balance between the two might be the key to finding fulfillment in both areas.

For now, I wait and hope that reaching out to Amirul will be a step toward strengthening my connections, both with others and within myself.

Amir is 4 years old this year. He mostly spends his days at the babysitter’s house and sometimes at his grandma’s.

Since last year, with my career shift into programming and more remote work, I’ve had the privilege of spending more time with him. Almost every day, we’d have breakfast together. Boy, does he love nasi putih and apam in the morning—that’s all he would eat! After sending Airis to school, we’d often wander around the neighborhood, looking for places to have breakfast.

After breakfast, I would drop Amir off at the babysitter’s and either return home to work or head to a café to get things done. In the evening, depending on when my work wraps up—sometimes at 2 p.m., sometimes at 4 p.m.—I’d pick him up, and we’d head home together. I’d cook while he played with his toys.

Next month, Amir will start playschool. I know that once he begins, he’ll need to have routines and structure. Our leisurely mornings of wandering around will inevitably be cut back significantly. I’d hate for them to disappear completely, though. T_T

It leaves me feeling a bit disheartened.

I think Airis has noticed. She’s definitely aware that I’ve been spending a lot of time with Amir—something she didn’t get to experience when she was his age.

Between 2017 and 2020, those were very challenging years for me. I was struggling and taking many medications—sedating, memory-depleting, mind-numbing ones. I was in a constant brain fog. It’s hard to recall memorable moments from that period with Airis. It eats me up inside, and it’s definitely something I’ll carry guilt for, for the rest of my life.

Recently, I watched the movie Babah. It sparked a lot of introspection. As much as I’m trying now—trying to make up for lost time, to be present, to create meaningful moments—I feel it’s still not enough. I feel I should have done more—created more memories, appreciated them more, spent more time with them.

Now Airis is already 10 years old. She’s mature enough to understand what she’s missing. She’s developing her own personality—her likes and dislikes, her moods. I find it harder to connect with her, to fully understand her world. I worry that I don’t show her enough love. I hope I can be a better friend to her, even if I struggle to be the father she needs.

Ultimately, as I approach my 40s in a couple of years, I realize how fleeting these moments are. These are phases I don’t want to miss. They’re ephemeral. In the blink of an eye, my kids will grow into a fine lady and gentleman, and I’ll be the old wrinkled man watching them from afar—hoping, praying that I’ve raised good people, good Muslims, and that they stand as proof that my existence in this world has brought some benefit.