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290 Orchard Road #06-06, Paragon Shopping Centre, Singapore 238859
For The Love of Insects

Anyone meeting Dr Francis Seen Choen for the first time is likely to be taken aback: by his spunky attire, rolled up sleeves, spiky hairstyle, and a constant grin or his face. His youthful look belies his age (he's not telling) and his profession as a medical surgeon, specialising in what he called "back passage plumbing" of the human kind.

He has a great sense of humour. If one looks beyond what he does for a living, it is not difficult to understand the vast amount of "dirt" he can harvest as fodder for his jokes, but beneath the jovial face, the tone is a serious one.

FROM PAEDIATRICS TO SURGERY

Graduated from the National University of Singapore in 1981 with an MBBS degree, he intended to be a paediatrician to be close to kids — his innate liking towards children. It was a new department and colorectal surgery was not that popular worldwide at that time. "I thought therefore that I will be able to become well known easier than if I remained a general surgeon," Dr Seow says. "Secondly, as it is a new speciality, I would be able to contribute much more to the treatment and discover much more about its diseases that if I had remained in general surgery."

Time proved that he was right. Eventually, he became the head of the department at the Singapore General Hospital but left for private practice in 2004. Under his guidance, the department has built up an impressive array of services which included endoscopic surgery, laparoscopic surgery (which now includes robotic surgery), ano—rectal physiology, trans-anal ultrasound services, molecular biology services as well as the whole range of training facilities.

Over the years, he has firmly established his name in the field of colorectal surgery. He is well known in the medical circle and travels extensively around the world lecturing and operating. In 1993 he was awarded the first American Society of Colon and Rectum Surgeons International Travelling Fellowship. In 1994, he was invited as the W Wallace Green lecturer for the St Luke's Hospital Foundation in Kansas to lecture or the treatment of Rectal Cancer and the use of the Colonic pouch.

In 1999, he was also the first Asian to be invited as the ESR Hughes Lecturer for the Royal Australian College of Surgeons and in 2004 he was the first Asian to be the Rupert B Turnbull Memorial Lecturer for the Cleveland Clinic, Ohio, USA. Further honours came in 2005 where he was again the first Asian to be invited as the Philip Gordon lecturer for the Canadian Colorectal Society. He is past president of the Asian Federation of Coloproctology and is still very active there — in visiting various countries in Asia to raise the standard of colorectal surgery.

Dr Seow is also the nominated founding and current President of the European Asian Colorectal Technology Association, a society dedicated to raising the standards of colorectal surgery in both Europe and Asia.

Now, a respected colorectal surgeon in private practice, Dr Seow has been at the forefront of coloproctology — the study of diseases of the intestines large and small. These include haemorrhoids, piles, constipation, diarrhoea, cancers, functional problems— concerning the activities of daily living, as he would say.

He adds that coloproctology is a new discipline in Singapore but since the formation of the first department here in 1987, it had become a beacon of light in this country. "Now every young trainee wants to be a colorectal surgeon as we publish the most papers, have the most vocal practitioners, have all the new techniques and perhaps have the most patients and therefore the potential to earn the most money," he says.

When asked what were some of his challenging medical cases, he explains: "As a professional, personally. I'm not looking at challenges, but solving interesting problems. When one is working within one's capabilities, one won't see many challenges. In terms of surgery itself, we do not come across challenges very often. Practice makes perfect. In the hands of experts, what is considered challenging in the eyes of the layperson is routine to us."

"Managing patient expectation is one big challenge – mainly what can be achieved, and what to expect," he says. "Dealing with quite difficult cases, although we can do the surgery smoothly, there are complications. Often, patients with advanced cancer have many problems, and things can go wrong. The challenge is how we manage such patients, and work with other experts to solve the problem."

"There are some difficult surgery to do, but as we have been defining the art and science of colorectal treatment, we've made difficult cases simple," he adds.

Sometimes, Dr Seow also has to contend with "knowledgeable" patients. "With the availability of the Internet, some patients think they know more than you, but what's being applied is not so straightforward," he laments. Still, it is deeply satisfying that he has managed to save the lives of patients who have come from abroad, almost at the brink of hopelessness. He recounts: "A Pakistani patient came to see me. He had big tumours, had been operated on in Pakistan, but the doctors there said they couldn't be removed. I felt it was within our expertise to remove the tumours and we did so successfully."

Dr Seow adds that he has seen some very interesting cases, more so in private practice than when he was working with a public hospital. Foreign patients make up a good size of his clientele, and often, because they had to save up enough money or had exhausted all possible avenues for a cure locally, arrived with late-stage growths and tumours. "These are rather interesting cases than challenging ones," he says.

SERIOUS FUN

Dr Seow is animal lover. He believes in treating animals well so that animals will reciprocate and enrich our lives. Apart from his professional obligations, Dr Seow is also the Chairman of the Guide Dogs Association for the Build, a nonprofit organization that helps train dogs to be the eyes of the blind.

He keeps two pet dogs, a cat, two birds and a host of stick insects, well kept in wired cages stacked on top of one another in a corner of his house. In fact, outside his medical profession, he is also a well-known authority on stick insects in Singapore and Malaysia, having published two books on such species here, another in Malaysia. His next book will be on stick insects of Borneo.

But why stick insects? "When I was young, I watched a lot of animal documentaries on television. I was fascinated by the mere variety of wild life but since I couldn't keep large animals like tigers and lions, I turned to insects. In fact, my ambition then was to be a zookeeper," he recalls. He got interested in insects because there is such a wide range of these little animals, some with very specialised ways of life while others can only be found during certain times of the year. "Insects are quite neglected by people around the world; people consider them as pests," he says.

He remembers that when he was still a very young boy, his mother collected some stick insects from the butchers in the market one day. He explains: "ln the old days, people kept them to collect their droppings, and made into tea for drinking for curing a whole host of conditions. Interestingly, stick insect droppings have very high concentration of Vitamin E, apart from mostly fibres." Dr Seow believes that there must be some usefulness in those droppings, but further research is necessary to confirm its efficacy.

"When I started collecting stick insects, I found them to be small and very interesting. However, there was no information on such small insects in Singapore. I talked to various organisations including the National Parks Board, to the NUS entomology department, and so on but they could not tell me more. At that time, experts said there were only about three or four local species, but I discovered there are 51 types of stick insects in Singapore!"

He was so keen in his research or stick insects that he has been invited several times to talk locally as well as overseas about them and help document new discoveries. No wonder he is an authority on such a subject that he was appointed an honorary fellow of the Royal Entomological Society, as recognition of his substantial contribution to entomology, through publications and other achievements.

"Do you know stick insects are the longest insects in the world?" Dr Seow asks. "There are several species which the males are never found. There are species that mate for life, some for days, some just for the moment. Some lay eggs that are struck to leaves, others pierce their eggs into leaves."

Dr Seow is also an honorary research fellow of the Raffles Museum of Biodiversity Research. ln fact, he is working with molecular biologists to learn how stick insects can regenerate new legs in place of broken or missing ones. That could have application in regenerative medical Research, he says.

A WONDERFUL WORLD

Dr Seow certainly has his hands full. Apart from being a surgeon, entomologist and a medical trainer, he is also busy writing his next book and accepting invitations to present his latest medical findings.

He still pays a fundamental role in the education of new trainees. But mentorship today is different from the days when he was a young doctor. The world is smaller and patients have more knowledge, he says, but not necessarily wider and therefore give more problems to a really caring and good doctor.

Nevertheless, he believes in living life to the fullest, and this wide, wonderful world of ours is for us to discover and to learn to be better inhabitants of this Earth.