In this episode, you’re going to hear from a psychiatrist on a number of topics directly and tangentially related to finances and financial decision making. Later in the episode we talk about some financial behaviours under acute mental distress, a number of various pathways that lead to hoarding behaviours, and more. But we also discuss the effects of chronic decision fatigue, burnout, and corona insomnia that almost everyone seems to be experiencing. And I need to point out that today’s guest, Dr. Ajmal Razmy is one of my very best friends. We studied neuroscience together during our undergrad days at UofT and he continued with his masters and medical school, whereas I, after my last undergraduate exam, went to auto-racing school.
Dr. Razmy is a psychiatrist and mental health specialist at Cleveland Clinic Canada with a background in healthcare with a special interest in sleep medicine and hospital administration. He is currently a practicing psychiatrist and Head of Service (HoS) for Mental Health at Joseph Brant Hospital with a focus on acute care psychiatry. In the HoS role, he is helping lead Burlington’s mental health response to the novel Coronavirus across the hospital and community systems. Prior to this role, he worked at Trillium Health Partners, where he was the Service Medical Director for Acute Care Psychiatry, and has also served as a psychiatry member of the Consent and Capacity Board of Ontario.
Links
Twitter: https://twitter.com/AjmalRazmyMD
Website: http://ajmalrazmymd.com/
Cleveland Clinic: https://my.clevelandclinic.org/canada/staff/razmy-ajmal
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Ajmal Razmy (00:00):
I've had many patients with bipolar disorder
(00:03):
during manic states, where youfeel lated you feel high, you
feel some grandiose thoughts.
And all of a sudden you have aFerrari F 12 in your, in your
driveway, right? And you knowthat. And maybe that's great if
you can afford it. But if a lotof people can't, and I've had,
I've had to write a couple ofletters to not Ferrari, but to
(00:23):
different companies saying that,Mr. or Mrs. So and So, purchased
this item under duress. And soyou know, it's a little bit of a
fight, but most most companiesunderstand, but not all.
Preet Banerjee (00:50):
In this episode, you're going to hear from a
psychiatrist on a number oftopics directly and tangentially
related to finances andfinancial decision making. Later
in the episode, we talk aboutsome financial behaviors under
acute mental distress, a numberof various pathways that lead to
hoarding behaviors, and more.
But we also discuss the effectsof chronic decision fatigue,
(01:12):
burnout, and Corona insomniathat almost everyone seems to be
experiencing. And I need topoint out that today's guest,
Dr. Agarwal, razzing me is oneof my very best friends. We
studied neuroscience togetherduring our undergraduate days at
U of T. And he continued on withhis master's in medical school,
whereas I, after my lastundergraduate exam, went on to
(01:35):
auto racing school as one does.
My parents are so proud.
This is mostly money and I'myour host Preet Banerjee, and
today's guest is one of my verybest friends Dr. Osmo rasmea.
(01:57):
He's a psychiatrist and mentalhealth specialist at Cleveland
Clinic Canada, with a backgroundin healthcare and a special
interest in sleep medicine andhospital administration. He is
currently a practicingpsychiatrist and head of service
for mental health at JosephBrant hospital with a focus on
acute care psychiatry. In thatrole, he is helping lead
(02:20):
Burlington his mental healthresponse to the novel
Coronavirus across the hospitaland Community Systems. He has
also served as a psychiatrymember of the consent and
capacity Board of Ontario, AajMa, my friend, welcome to the
show. prayed this is a dreamcome true. Thank you for having
that.
Okay, so I don't want to go wayback. So I think he's going to
(02:43):
maybe reveal a little bit ontoday's podcast. Before we start
that, I wanted to say why Iwanted to have you on this
podcast a couple of reasons. Oneis to talk about how the
pandemic has been affecting ourstates of mind, and how that
translates into performance notonly at work, but also with
making financial decisions. Andthis is something that you and I
have talked about quite a bitover the last, you know, 12
(03:06):
months, 18 months. And secondly,I wanted to ask you about areas
of personal finance, that don'treally get covered a lot in the
personal finance sphere thatmuch or at all. And that is when
financial decisions are madeunder acute mental crises, or
psychiatric disorders. So wewant to talk a little bit about
(03:27):
that, and your experiencedealing with some of the
financial aspects when it comesto you know, when you're dealing
with patients. Now, I alsowanted to actually start with
expressing gratitude to you andTina for the listeners, Tina's
his wife, also a physician, andall the colleagues that you work
with who are part of thehealthcare system battling
(03:48):
during this pandemic, because Iknow, it's been taking an
incredible tool, you know, noton just society as a whole, but
also everyone working inhealthcare. So thank you so much
for what you guys are doing. Ithink it's amazing. And my first
question is, how are you doing?
Dr. Ajmal Razmy (04:06):
Well, we're taking it day by day, truly is a
remarkable experience. I think,the way that I've wrapped my
head around just personally,this whole experience is just
thinking about this as aas a once in a lifetime,
hopefully, opportunity to toreally, you're in the middle of
history. Right. So I'll give youan example. At the hospital
(04:28):
where I work at St. Joseph'sJoseph Brant Hospital in
Burlington, you know, we areactually considering at this
point, redeployment ofphysicians to different areas of
the hospital they've neverworked with before. And so you
can take that, like, Oh my god,like, what am I going to do? I'm
(04:48):
a psychiatrist, how am I goingto like, you know, put an IV in
someone or I think you can kindof take the the growth mindset
of saying, Wow, I've now I'llprobably never be asked to do
this again. And I'm going to beworking with other people who
have a certain expertise. Andwe're going to work in teams.
And, you know, this is this isone of those like photo book
(05:09):
moments where you, you'll neveryou'll be able to tell this to
your, your grandkids, that wewere in this scenario, and we
How did we kind of bind togetherto make it through this. And,
for me, that's what keeps megoing is, is understanding the
historical context of wherewe're in, and also lining that
with some optimism that we willgrow to a different perspective
(05:31):
to a new world, and hopefully,to a better one, and that's
honestly, I take every day,
Preet Banerjee (05:38):
you know, I on one hand, I'm not surprised
that, you know, your perspectiveis, is has that sort of
framework, you know, you youbasically you're talking about
your coping strategy with this.
Incredible, like I said, once,hopefully once in a lifetime
scenario, but not everyone hasbeen able to sort of see it with
that same perspective. And Iknow, it's like been wearing a
(06:01):
lot of people that are includingphysicians, and I remember, we
were chatting because it was inthe news, you know, as a couple
of physicians who took their ownlives because of the stress and
dealing with what was going on.
And I remember that you werecalled by the media to talk
about what was going on. Becausenot only are you in the
healthcare system, you focus onpsychiatry, and how people
(06:24):
think. And so what might comenaturally for you, and in
creating these coping mechanismsand strategies to help get
through this for yourself, isforeign for a lot of other
people who are struggling rightnow. So I guess that's kind of
where I wanted to start is to,if you can go back to the
beginning of the pandemic, whichwas, you know, I guess, 14
(06:47):
months ago, but it feels like onone hand, yours, and at the
other time, it feels like, Idon't know, maybe it was just
like, it feels like it couldhave been just a couple months
ago, because time is so blurredtogether now. And I think that's
one of the first things thatpeople noticed was when we went
into lockdown. We didn't evenknow what day of the week it was
anymore. So can you walk usthrough what happened during the
(07:09):
onset of the pandemic, in termsof just our overall outlook on
our regular daily lives?
Dr. Ajmal Razmy (07:18):
Yeah, for sure.
And I think I mean, you likeFormula One? Right. So there's
been a lot of sort of shiftinginvolved. I think, you know,
there's been Sprint's andmarathons, and then sort of just
fatigue that we've we've beenoscillated amongst these waves.
I mean, I guess we're speakingfrom a Canadian perspective, but
certainly globally has beenexperienced differently based on
(07:39):
how the pandemic has impacteddifferent countries. But I think
initially, there was a lot ofuncertainty, a lot of fear.
Maybe a bit of denial. Oh, yeah,this is Yeah, I remember. I
mean, personally, I rememberjust thinking, well, this is
probably something localizesterrible, something localized
(08:00):
in, in, in Asia, and, you know,I don't just we've heard about
little things like this before,and maybe it'll be just
localized and, and hopefullycontained and dealt with, and
then as it was encroaching andimpacting Canada. Yeah, people
were like, what is this? What isthe nature of this, and we had
the backdrop of SARS, I guess,in the early 2000s, where that
(08:24):
was a very localized in withinthe hospital kind of condition,
and, you know, didn't seem toobad. In fact, I was a medical
student during that time, and itwas actually, to some medical
students, you know, it was agood learning experience, but
wasn't devastating, like us. Andso, I think we, we, we started
off in the sprint and this kindof chaos of anxiety and fear and
(08:48):
not knowing where this is goingto go. And then having that kind
of like that break of Okay,well, this is the first spring
and maybe that was it, is itgone? Is it not gone? You know,
quote unquote. And then I thinkthe subsequent waves have really
sort of like piggybacked on theinitial fears, and have gone
(09:09):
from the acute distress to moreof a chronic toll on people,
people's mental health. Andthat's what the data shows, too.
So we're in our third wave andin Canada, and the rates of
depression and anxiety are thehighest that they've ever been.
And in particular, some of therisk factors, the drivers of
(09:30):
that work from home, socialisolation, and a lack of
optimism, just because it wasyet another way. How many more
do we have to go through thatkind of thinking? It's been
devastating.
Preet Banerjee (09:45):
One of the things that we saw was the the
toilet paper hoarding. It wasmaking news around the world,
you would see pictures of justempty aisles at grocery stores.
Why did that happen? What whatwhat caused people to say, Hey,
this is the thing that I need tostock up on.
Dr. Ajmal Razmy (10:06):
While crises can bring out some interesting
human behavior, I think,remember, we're also like, I can
only speak locally in Canada,but we're also a country of, I
guess, immigrants in a way, likepeople who've made this a home
for themselves. And it really issuch a beautiful country in that
(10:26):
regard. But we also bring ourown traumas to this. I remember,
like my folks there from ofGhana, Stan, and and when this
was happening, they right awaygo back to like when they were
fleeing from Kabul, and it'slike, Okay, well, you know, you
better stock up and you betterbe prepared for whatever is
going to happen. And, and sopeople, I think there was a
(10:48):
cohort of individuals that thattheir previous traumas of
experience coming to thiscountry may have been triggered.
But I think there's just masshysteria, there's people with
uncertainty, people act in verystrange ways, financially and
otherwise, as we'll discuss. Butit's interesting that I think
that has become less and less ofan issue, as the waves of have
(11:11):
gone forward. But you might seean initial spike of it each
time, there's another way. Andthen it kind of dies off again.
Preet Banerjee (11:18):
And so you talked about how Initially, it
was more acute stress andanxiety, and now it's switched
to more of a chronic burden thatpeople are dealing with, that's
creating burnout. So can youtalk a little bit about burn,
because I know you've beenstudying, you know, the burnout
that's being exhibited now, aswell as what I think you call
(11:40):
Corona insomnia. And I havespoken anecdotally, to a number
of people who've had a number ofsleepless nights. And I'm
wondering, is there some kind ofcommonality? So let me know
what, what you've been studyingin, in the area of burnout and
how it affects us?
Dr. Ajmal Razmy (11:59):
For sure, I mean, it's, I'm also like, my
area of interest is preventativemental health and wellness. And
so within the hospital I workfor, for I, I'm their wellness
lead, I guess and so within thatbracket there, you know,
(12:19):
hundreds of physicians that, youknow, I am in some ways
responsible for for theirwellness and trying to help
address that. So for me, burnoutis is an absolute passion,
partly because, you know, I've,you know, like many people I've
been through too. But burnout,the problem with burnout is it's
like many terms in mentalhealth. It's kind of overused,
(12:40):
like what is depressed means ifyou had a bad day, or, you know,
Blue Jays loss, are you reallydepressed? I guess it depends.
But, you know, the, the terms inmental health can often get
blurred, because they become alittle bit too common in the
vernacular. But burnout is aterm that's been around for
decades. I the best researchdone on burnout, the highest
(13:05):
quality, I would say is byChristina maslach out of
Berkeley, who has studied thisfor since the 80s. And, and only
recently, the World HealthOrganization has identified
burnout as an actual condition.
So in their InternationalClassification of Diseases,
their latest version of 12 lovetheir 12th edition and 2019,
(13:28):
they came out with actuallydefining what burnout is about.
Interestingly, they classifyburnout as an occupational
phenomenon. So depending onwhich organization you're part
of, people may not like to usethe term burnout, because it may
reflect some sort of perceivedflaw by the organization to
address sort of a toxicenvironment, if you will. But
(13:51):
there are three sort of Cardinalcomponents of burnout. In no
particular order. The number onesort of, quote unquote symptom,
although it's not a it's not asymptom, it's part of a syndrome
is a exhaustion. So that tiesinto the cronyism, which we'll
talk about, but just feelinglike completely an utterly wiped
(14:13):
out. People have been there, butthis is sustained, right, every
day feeling the same way likethat. The second sort of
component is cynicism. theraising of the brow, the, you
know, absolute disregard, oralmost discontent, I guess, with
(14:34):
policymakers, whether it'sgovernment or your organization,
people work for etc. People wholay down the rules, just people
becoming increasingly cynical,if you find that's happening,
that's another component, andthen just not feeling effective.
Not feeling like you're doingyour job right. And I think at
some level, many of us, myselfincluded, you know, we Just the
(14:58):
nature of being sort of alphadriven, if you will, can have
these components and it's notone. It's not just the
exhaustion. It's not just thecynicism. It's not just feeling
ineffective. But it's a littlecomponent, a little hybrid of
all of these things, a Venndiagram, that if you have over a
sustained period of time, likelyyourself suffering from burnout,
(15:19):
the important point and Dr.
masstige very elegantly bringsus forth is that burnout is not
a me problem. But it's a weeproblem. It's something that's
endemic to the system that'sthat's built around you, much
(15:41):
like environmental toxins andstuff like that. And in
workplace it's, it's, it'ssomething that's endemic to the
the organizational structure.
And certainly, I would saybefore COVID-19, burnout was
rampid, in many differentorganizations, especially in
healthcare. But this is justsort of, I think, the COVID-19
is served as an accelerant toall of those problems related to
(16:05):
burnout.
Preet Banerjee (16:09):
When it comes to the burnout that's being
exhibited by people, myunderstanding is that people
with kids, single parents, twoparent households, when you have
kids, it seems like they're juston a totally different, like
quantum level, because they'vehad to deal with what do we do
with the kids? What are theschools doing? What is the
(16:30):
government saying? The rules arefor, you know, going back to
school online learning ordaycares open? What's open,
what's closed? And why are wegetting these messages with, you
know, like, 24 hours notice,juggling that with your work and
making concessions. Do you haveany insights into you know,
what, what categories of peopleare being affected most right
(16:51):
now? With respect to burnout?
Dr. Ajmal Razmy (16:54):
Yeah, for sure.
I mean, it's interesting, right?
Everybody experiences at adifferent level? I would say the
millennial, the millennials alsohave a different type of
burnout. You know?
Preet Banerjee (17:09):
Oh, tell me more about that. What do you mean by
a different type of burnout?
Dr. Ajmal Razmy (17:13):
Well, this is just the way I see it. But I
mean, you can imagine people whoare sort of early on in the
career just like maybe you justlanded your, your job with the
organization of your dreams. Andyou're like, Okay, I want to
start where my mentors and boom,everyone's like, gone virtually,
right. There's none of the whathappened to the, you know, sort
of like shadowing along withwith some of these more senior
(17:38):
vets within your organization,and just feeling that sense of
like, not necessarily belonging,which is like an important
component of resilience, forexample. So I think millennials
feel that kind of isolation,maybe devalued, a little bit. I
think there's been a lot of talkabout the parents and people who
(17:58):
have kids, and that kind oflike, hug a little bit of the
sympathy around burnout, andrightfully so, as a parent,
like, it's, it's true, but Ithink that the millennials,
themselves, if you know, forthose that are single and, and
or, you know, with our children,they've also had a very
(18:20):
different struggle, and I don'twant to minimize that. But when
you look at the, the data inhealthcare, so we look at
healthcare industry, it's beenthe, the Gen X population that
suffered a lot kind of TheInbetweeners, right. So you're
kind of like dealing with like,aging parents, and you're
dealing with like, you know,breastfeeding or whatever you're
(18:42):
dealing with. And so you'reright in the middle there. And I
think, for how that's that'sproved to be a sticky point.
Depending on the way yourorganization structured, it's
important to look at thesedifferent categories and
understand and appreciate thateveryone's impacted but just
differently, right?
Preet Banerjee (19:01):
Yeah, cuz I would, one of the things that
I've noticed as well is, youknow, if you're younger, and
you've been living on your own,maybe you don't have a life
partner, yet, you've gotisolation and being isolated
with everything that's happeningright now, is a different sort
of stress than the stress of youknow, having family and kids and
dealing with, you know, overloada different sense, because you
(19:24):
can say, well,
Dr. Ajmal Razmy (19:25):
so that the person who's isolated can say to
the person who's not saying thatwhat you have your husband and
you're not alone, and blah,blah, blah, and then you know,
that person, that person Yeah,
Preet Banerjee (19:36):
I've got my husband and I'm not alone.
Dr. Ajmal Razmy (19:41):
Oh, yeah. It's hilarious, but it's, it's, it's
hilarious to talk about, butit's certainly very stressful to
experience. Yeah,
Preet Banerjee (19:47):
well, yeah. I mean, you and I, obviously,
we're friends and we joke aroundall the time. So there's going
to be a bit of levity here, butthat is also part of a coping
strategy for a lot of people aswell finding, trying to find the
humor where you can becausethere's so many things Just
bring us down right now. Yeah.
So let's talk. I think this isreally a good segue, because
we've talked about thesedifferent sort of situations,
you know, families, individualsliving in isolation. And then
(20:10):
there's been, there's been thisapparent exodus from city
centers into, you know, therural areas, and people are
looking at moving to, you know,the East Coast. And there's,
there's just people migrating,apparently, to the city centers,
people don't know if that'sgoing to be long lasting or not,
but what can you What can youtalk about in terms of why this
(20:31):
is happening, and what you'vebeen what you've been seeing?
Dr. Ajmal Razmy (20:38):
Yeah, I, again, full disclosure, I'm not a
financial expert, by any means.
But I think, you know, justbehavioral sort of analysis
here, the reptilian brain ispowerful man, it can really do
it, you know, the tail does wagthe dog, in many cases here. And
I think that when people areunder distress, and there's a
(21:00):
lot of uncertainty, you know,decision making in financial
decision making just part ofthat people can make interesting
choices. I, you know, there'sI've treated some of my patients
that have moved on from, youknow, urban centers, to more
quieter settings. And, you know,some, some are very happy with
(21:22):
that, and others are saying,Hey, you know, what, what did I
do this board is all of all thatI have around me a couple of Tim
Hortons, and I don't know, Imiss Toronto, or I miss the
urban life. But when I go backthere, everyone's wearing masks,
and we get doing so but butagain, that's a very narrow
perspective. Right? So to methat's speaking and those
examples of how during fight orflight kind of thinking,
(21:44):
people's decisions are become alittle bit skewed. And I think,
from from what I understandabout financial decision making
as well, the motions take a bigpart, and they kind of like,
they actually take over thecognitive processes and many
times, right, and so I thinkthat's, it's probably a little
bit of that I would anticipate,from a mental health perspective
(22:06):
and from like, like, a brainscience perspective, that
that'll probably course correcta little bit as time goes on.
Preet Banerjee (22:16):
Yeah. And I think tied to that, we've also
seen pretty strong increases inhousing prices. And we're
seeing, you know, incrediblebidding wars, we're hearing
stories about houses going upfor sale, and there'll be like
49 competing bids, people arebidding 400,000 over asking, and
people are talking about FOMO,the fear of missing out on
getting in on a housing. And soit's causing a lot of people to
(22:37):
really stretch themselves thin.
And we're not talking aboutpeople would show up in the ER,
in some kind of, you know, acuteepisode of mental distress. This
is like, you know, a lot ofpeople, what can you What can
you say about the fear ofmissing out or keeping up with
the Joneses? how prevalent isthat in people? And how much of
an impact does that have on ourfinancial decision making?
Dr. Ajmal Razmy (22:58):
I think it's huge. I see it all the time.
I've had I've had a handful ofpatients over over the course of
this winter, that you talk aboutFOMO. But they're also kind of
what is called buyer's remorse,as well. And they were in
(23:20):
situations where they were outbidding, and it became personal,
on a property. And they ended uppaying way more than they wanted
to, but they just wanted toclose it. They didn't want to
give it up at some point. AndI'm sure many, many of the
listeners have been in thosescenarios. And it's almost like
when you're in that zone, it'slike you're playing roulette, or
you're at a table in Vegas, andyou just can't stop. So it's an
(23:44):
interesting phenomenon. And butthere's something innate about
wanting once you're kind of likecommitted this kind of fear of
losing out on on what you thinkis right. And and people, I
guess it's evident right now,especially in, in Ontario, I
guess, just people really payingthrough the roof. And it's
(24:07):
interesting, it's going to beinteresting to see what people
think six months down the roadwhen things kind of swing in
different directions.
Preet Banerjee (24:13):
One last thing I want to talk to you about the
pandemic before we change gearsa little bit, and that has to do
with this Corona insomnia. So Ipersonally have had a number of
nights where I am just awake allnight long. And you know, I keep
on maybe rationalizing to myselflike I have a such an unusual
schedule. You know, I don't haveto be anywhere at 9am in the
(24:35):
morning, whether it's online orand I don't go anywhere anymore.
Every now and then I'll do amorning radio show, which I have
to get up at 5am to do some prepfor occasional do morning TV
shows maybe once every two weekskind of thing. But other than
that, you know, I have no realset schedule. So I thought well,
maybe it's just because youknow, I go to bed and wake up at
(24:56):
totally different times all thetime. And my body's just like
Yo, what are you doing? Keepyour mind. But I think I'm not
alone. Because I've been hearingfrom a lot of people that
they're just up all night, andit's something that they've
never experienced before. So Iknow you, you and I have talked
a little bit, you've talkedabout something called Corona
insomnia. So what is that?
Dr. Ajmal Razmy (25:18):
Yeah, so I'll wear my Sleep Medicine Hat. Now,
but Corona insomnia. I wish Icoined the term myself. But it's
something that's used sort of inthe sleep medicine world to
reflect the sleep disturbancethat's been sort of triggered.
During COVID-19. It's been seenon all across different sleep
research centers. throughoutNorth America, and globally,
(25:43):
actually, some of the data justcoming through now. I mean,
insomnia is a very commoncondition. If we think of sleep
in general, like if we take astep back, sleep has a
homeostatic function. So like,basically, as the day goes on,
there's this drive for sleepthat builds. And it also,
there's also a circadianelement, which is based on light
in training, our sleep patternsand, and so if you think of,
(26:07):
just from that mechanisticperspective, you think about the
pandemics done in terms ofpeople working from home and
working at different hours andmaybe not taking breaks, and
having all this blue, blue lightthat's they're exposed to
through their devices allthroughout the the night,
potentially, it's no wonder thatboth the homeostatic and
(26:29):
circadian functions of sleep arekind of like offset. And so
we're seeing a sleep researcherseeing both an increase in
insomnia, so people havingdifficulty either falling or
staying asleep, and alsohypersomnia, where some people
just because they have noschedule, or like going to bed
at like, midnight, we're notwaking up till noon. So
Preet Banerjee (26:53):
yeah, there's some nights I get up, I was
like, I just cannot get out ofbed. And
Dr. Ajmal Razmy (26:58):
it speaks to how important I think routine
is. And it also speaks to thatfunction that work actually
plays, you know, I think interms of having, you know, the,
the kind of like, if you thinkof how many hours are you
actually productive at work now,you're probably an exception,
you I'm sure you have a veryproductive all the time,
Preet Banerjee (27:15):
two hours, tops.
Dr. Ajmal Razmy (27:16):
Yeah, I was saying for myself, maybe half an
hour. If I'm good, and but it'sall the other stuff, it's all
the other scaffolding of likegetting up, hopefully showering
once in a while driving to work,you know, saying hi to Tim
Hortons person, or whatever, orif you work at Tim Hortons,
saying hi to your colleagues.
And then coming back, you know,and and so all of those things,
(27:38):
that that what I call thescaffolding of work is is
stripped away. And so you know,what you're left with is, you
know, for a lot of people, Idon't you find, but work from
home has actually increaseddemands on productivity, I think
people are actually working moremuch more than when they were
going into their office spaces.
Preet Banerjee (28:03):
Yeah, and we talked about, you know, the, all
the things these demarcations oftime, you know, that you have
with a routine that is justblown out the window, when you
know, when the restrictionstarted and work from home for a
lot of people. Because Iremember back when I did used
to, you know, go to an officeand work, everything was such a
(28:26):
routine. And if I wanted to workout, I would have to plan around
my work schedule, say, Alright,if I'm going to work out, I got
to get up at five, get to thegym at 530. I got to get home
shower, and then make it towork, leave by a certain time.
You have your breaks at acertain time of day, you have
your lunch break, maybe you havethe same people that you hang
out with at lunch, you got yourafternoon, break, the end of the
(28:48):
day, you've got some time todecompress on the way home and
change gears from work life tohome life. And that all changed
when I you know before thepandemic when I went, you know,
completely self employed Justwherever myself, I find it was
harder to get a lot of thingsdone unless I reinstituted some
kind of routine or schedule intomy life. Otherwise, it was
always I could do it any timebecause I have no Boss, I could
(29:10):
just fit in in whatever I want.
And that would never fit it inunless I put it into my
schedule. And then now with apandemic, I think everyone is
sort of experiencing all thosethings that we had that that was
our routine, our scaffolding, ifyou will, is gone, and
everything is blurred together,you're at home, you're working
from home and your kids are homeand they're like, hey, I need
(29:30):
lunch or, you know, we need toget out and get some exercise.
And so you'd be working and thenthe next minute you're, you
know, home life, and then you'reright back to work life. And so
the there was no there was nochange from home life to work
life. It's all sort of blendedtogether. And I think that that
has taken quite a bit of a tool.
(29:52):
Now we've talked a lot about,you know, the burdens on people
whether it be through burnoutthrough disturbing Isn't sleep?
How do these things affect ourability to make financial
decisions?
Dr. Ajmal Razmy (30:07):
tremendously. I just want to make one quick
point. So although the pandemicis kind of like hit our
workplace structure, like ameteorite and kind of blowing
things up, I think it's alsouncovered some other like
positives, too, right? Like,there's lots of people actually
like the flexibility and maybedon't always want to commute
maybe there's maybe that has abenefit in terms of our own
(30:29):
carbon footprint as well. And,you know, what are some of the,
I guess, to when I speak to CEOsof companies we talk about?
Like, what are some of theopportunities to really take
some of the pluses that thepandemic has served for the
average worker or for themanager, middle management, or
even CEOs? Like how do we likerestructure things for the new
(30:52):
corporate athlete to reallysurvive in this new terrain? I
think there are a number ofpositives. I mean, I've enjoyed,
you know, having the flexibilityto work out more, you know,
whether it's using the bike orwhatever. And, and sometimes
actually seeing my kids a littlemore because they happen to be
home too, right. So that it'snot all doom and gloom. And I
(31:13):
know, you're not saying that atall. But I think how do we how
do we take some of those thingsand work in this hybrid
structure going forward? So thatthat is not all bad? Right? So I
do think those are options. Ithink a lot of people are
looking at that. And I'm excitedto see what the new corporate
landscape will be.
Preet Banerjee (31:32):
And do you have Do you have, cuz I know you work
with corporations to talk aboutstuff like this, because this
is, you know, productivity iscore to many organizations. And
and I agree with you, 100%, Ithink a lot of people's eyes
have been opened to, hey,there's a different way of
working. And that's part of whyI would never go back to to work
(31:52):
for a big organization in anoffice commuting to it, I could,
once you've tasted what it'slike not to have to commute. For
me, I don't think I could evergo back. But I think a lot more
people are realizing, hey, notonly is it possible, because
they were forced to do it. Butit turns out that there are some
benefits to it. And I think somepeople say, hey, when things get
back to whatever the new normalis, maybe there will be a
(32:14):
different split. So what haveyou been hearing from from CEOs
that you consult with? about,you know, organizations and Nv
structures? What do you what doyou think is going to happen?
Dr. Ajmal Razmy (32:25):
So what I'm really encouraged about is, and
this is some of the work I dothrough Cleveland Clinic Canada
is, is the pandemic has given anopportunity for corporations to
also look at the work lifebalance in a true way. And
really looking at what is theROI on mental health and well
(32:48):
being. And so adapting to thehybrid lifestyle in terms of
work, but also going forward interms of how that's going to
impact the organization and howthings are structured. It's
actually put wellness at thetable of conversation, not just
lip service. And I think themessage that I try to send out
(33:10):
when I'm when I'm doing some ofthese sort of engagement points
is how do we win with beta. Andwhat I mean by that is, there's
been a cost with always havingsort of alpha producers within
your organization in terms of gogetting and not stopping and
going, you know, 110 miles anhour every day, in terms of the
(33:32):
results and impact on burnout.
And so when I say winning withbeta, I mean, adapting whether
it's a hybrid, corporatelifestyle, whether it's making
more time for breaks, whetherit's making more time for
exercise and nutrition andmindfulness. Are you actually in
the long run more successful asa beta organization? Or do you
(33:53):
want to have a bunch of alphathoroughbreds in your corner?
It's it's an interesting debate.
I'm not saying one is right orthe other. But I think there are
some benefits to considering thebeta approach.
Preet Banerjee (34:06):
That's, that's interesting. For my listeners
who are more financiallyfocused. Alpha and Beta mean
totally different things in theworld of fine. Yeah. However,
winning with beta is actuallykind of an overarching theme in
the financial world as well.
It's associated with indexinvesting anyways, I don't want
to nerd nerd out on that toomuch. I want to go back to a
question that asked you butbefore we do that, Cleveland
(34:28):
Clinic, this is Oh, I don't knowif you've been to other
Cleveland Clinic locationsaround the world. When I was
working in Abu Dhabi once thehotel room that I was staying
in, right across, there's Iguess it was a manmade River.
There's the Cleveland Clinic,Abu Dhabi. And this place was
huge, and at night, it had likethis glowing lattice all around.
(34:53):
It looked like a club likehonestly, I thought, like, you
go there to get treated or yougo there for ball. service like
it was insane. Have you seenthat one?
Dr. Ajmal Razmy (35:04):
I haven't been there. But I've seen it. It's
absolutely spectacular. Yes.
Preet Banerjee (35:16):
The conversation with Dr. Arch Mel rasbian
continues in just a minute. Butfirst, a few thank yous to
listeners who left comments onApple podcasts. jtb. Good. Thank
you for your very kind comments.
And Rajiv, who goes by themoniker, Surrey old timer. Thank
you, as well for leaving a kindof review. And thank you to
everyone who leaves ratings andcomments on Apple podcasts. I
(35:38):
appreciate them. And I do readthem all. And now, back to the
conversation with Dr. octanol.
resume.
(36:00):
Let's let's go back to thequestion I asked you about the
impacts of burnout, and cronyinsomnia on people's financial
decision making, you said it wastremendous. But tell me more
about that.
Dr. Ajmal Razmy (36:10):
What I'm seeing is some more desperation, in
terms of like narrow, like anarrow mindset in terms of like,
you know, what is what are thelong term forecast looking here,
like your Do we need to get outof urban centers and buy rural,
for example, we already spokeabout that. What about, you
(36:30):
know, investing in things thatyou would normally wouldn't do,
right, making, like decisionpoints that just don't make
sense. And you see itfinancially, but you also see
it, you know, in terms ofeveryday decision making with
with some of the people thatthat I see on an on a regular
basis, and it has liketremendous impact on their well
(36:50):
being. An example is, and thisis not a financial decision
point. But it's in terms ofcoping, right. Some people buy
things to cope. I mean, I'm surelike, how many Amazon boxes do
people have people sort ofcollected and have to get rid
of, right? It's like a wholebusiness to get rid of these
boxes? And I would say, that'slike, why did I buy those? You
know, why did I buy those, like,eight t shirts that are all the
(37:13):
same? They don't fit me? Youknow, and they come into these
boxes, and you're like, what amI doing with all this stuff? But
I think there is some some ofthat happening as well. But it's
interesting, because I thinkwhen you get into that kind of
state of being overwhelmed,being ineffective, feeling
cynical, it definitely impactsyour cognitive abilities to make
(37:37):
sound decisions. And I've seenthat trickle down in terms of
financial decision making aswell. Yeah.
Preet Banerjee (37:43):
Let's shift gears a little bit. And I want
to talk to you about some of theextreme financial situations
that you've, you've seen yourpatients present with. And you
end to put it into context. Youknow, when when you're dealing
with people you're not dealingwith, with people who sort of
(38:05):
say, hey, I need to talk tosomeone, I got some problems to
work out, you know, let me finda therapist to work with. You're
dealing with people who arelike, facing trauma, like when
they present to you like, like,things are dire. Right. So can
you can you sort of talk aboutsome of the extreme situations
that that you see, in terms ofthe financial aspects?
Dr. Ajmal Razmy (38:27):
Yeah, for sure.
I mean, whenever So, in general,when I asked my patients
questions about like, what whatare your main stressors in your
life right now? Certainly, Imean, right now, COVID is at the
top, but it's alwaysrelationships and money are the
top two things that come outalmost every time I assess
(38:47):
somebody. And and so I thinkthat's, that tells you about the
indelible kind of like, arelationship between money
matters and mind matters and howhow the two, sort of toggle one
another and, you know, there's anumber of different mental
health conditions that impactthat, I mean, classic examples
(39:09):
or not, I've had many patientswith bipolar disorder. During
manic states, where you feellated you feel high, you feel
some grandiose thoughts, and allof a sudden you have a Ferrari F
12 in your, in your driveway,right? And you know, that and
maybe that's great if you canafford it, but if a lot of
(39:32):
people can't, and I've had, I'vehad to write a couple of letters
to not Ferrari, but to differentcompanies saying that, Mr. or
Mrs. So and So, purchased thisitem under duress. And so you
know, it's a little bit of afight, but most most companies
understand, but not all, and soand the financial toll that,
(39:55):
like bipolar, surfing, take on afan. Emily, for example is
devastating, right. Andsometimes people never recover.
Certainly, there's cases ofpeople with dementia. And, you
know, maybe their financialcapacity hasn't been
established. And they'reselling, I've been on cases
(40:18):
where they've sold their entireestates to random strangers that
they've just met, for example.
And so that all of the, youknow, working back through that
kind of messy situation withfamilies, etc. Or you have
family members trying to takeadvantage of people whose
faculties are, are weathering,unfortunately, I want to make a
(40:40):
point A lot of people withmental health and mental illness
in general make great financialdecisions as well. But it's just
that finances relationships arevery, very fragile when your
mental health is in duress. Andright now, with with the
pandemic, going from acute tochronic, we're seeing that
(41:01):
impacted in various ways.
Preet Banerjee (41:04):
I actually had a situation maybe about a year
ago, someone who reached out tome, I hadn't spoken to them in a
couple of years. And they werelooking for help to rebuild
their, their financial situationin general, because they were
bipolar. And during a period ofmania, they had gone on an
(41:24):
extreme spending spree. And sothey just bought anything and
everything in sight. They justfelt good and felt like, you
know, they were invincible. Andthen it caught up with them,
because, you know, eventuallyall their credit cards got maxed
out. And and then I guess, Idon't know the details of what
happened later. But I'm assumingthe mania ended, and then
(41:45):
reality sort of set in, and theyhad to dig themselves out of a
big financial hole. And so thesethings can become quite extreme.
Another area that I know gets alot of attention, and and I
think sometimes is almostglorified, at least for
television purposes, ishoarding, like some of the most
(42:05):
popular shows are coveringpeople who hoard things, right.
And people gawk at them andwhatnot, but it's really, it's
really quite, you know,disturbing, and I really feel
for them, because from what Iunderstand, it's not something
that they just say, Hey, youknow, I think I'll just collect
stuff. There's there's somethingmore behind it. Can you talk
about what is sort of, like theunderlying factors with extreme
(42:30):
hoarding?
Dr. Ajmal Razmy (42:32):
Well, I mean hoarding is, I mean, that's,
there's different sort ofpathways to that. One pathway is
almost through obsessivecompulsive disorder. And there's
certain obsessions about likecollecting things and not
letting them go, for example, orhaving a fear that if you were
to let something go, somethingbad would happen to somebody
(42:53):
else. And, and so that's from ansort of an anxiety spectrum
issue where people hoard,oftentimes, people with dementia
or when they start havingcognitive disorders, for various
reasons are just like, not ableto process why they're there
keeping on to certain things.
And so basically, it's aweathering of your brain in that
(43:16):
condition. So there aredifferent pathways to hoarding.
Yeah, it's, it's, it does breakyour heart, when you hear about
that. It does affect a lot ofpeople, I would say most of the
people that I've ever treatedwith with hoarding behavior were
more from the cognitive disorderspectrum, usually, usually is a
sign of like some sort ofAlzheimer disease, a
neurodegenerative condition likethat, that's where I've seen it
(43:38):
mostly. But again, often notseen. And you may not even know,
right, so somebody in your bankis just coming in walking home.
And if you ever go to theirhouse, you see that there's a
sandwich on the table that wasthere from, you know, last
Christmas, and it's just there.
So I think there's a number ofchronic illnesses, that mental
(44:03):
health illnesses that can impactpeople's financial decision
making capacity. Most of thepeople actually you're not in
that state. And I think thatwithin the pandemic, there's
sort of like a lighter sort ofinflection points related to
this, but you're seeing it indifferent ways. I think mostly
from sort of an anxietyperspective where people are,
(44:24):
are making decisions that theynormally wouldn't
Preet Banerjee (44:28):
want to ask you about your your work on the
consenting capacity Board ofOntario. First of all, can you
explain what that board is?
Dr. Ajmal Razmy (44:38):
Yeah, so it's basically a a multi disciplinary
board, which consists of ausually a mental health or
psychiatry member, a lawyermember and a community member
that helped make decisions wherepeople aren't usually where
(45:01):
people are related to theircapacity to make decision
makings, if they've been ifthey've suffered from a mental
illness, or their consent tocertain treatments, for example,
or being in hospital, againsttheir will, for example. So
yeah, it's my work that I didwith the board is really quite
(45:26):
quite a privilege to be able towork with with them. And they do
great advocacy for peoplesuffering from mental health
issues.
Preet Banerjee (45:35):
And, you know, this, this idea of consenting
capacity is something that'sbecoming a bigger issue in the
financial services. Soregulators are now putting a lot
more attention, they haven'tignored it before, but they're
putting a lot more attention topeople who are older and may not
be able to make decisions intheir own best interests due to
(45:57):
whatever dementia orAlzheimer's, whatever could be
affecting their ability to makedecisions, especially when
you're older, you know, maybeyou've got a bigger portfolio,
you've had more time toaccumulate money, it's more
people want to take advantage ofyou. Or you have family members
(46:17):
who are trying to take advantageof you. And so they may have
decided a while ago, I'm goingto put someone else in charge of
these decisions. And sometimesthey may not make decisions that
are in the best interest of thatperson who's assigned them that
power. So what are the generalthings to look for? And this is
a tough one to sort of, youknow, provide advice to people
(46:40):
on but you know, if you've gotpeople around you, or you're
worried about your own capacityto make decisions, what are the
signs that someone doesn't havethe capacity to make their own
decisions?
Dr. Ajmal Razmy (46:54):
Right? Well, just if I could take a step back
to I think what's interestingfrom a societal perspective is
if you ask millennials, how theyfeel about baby boomers, right?
They're like, Oh, man, thoseguys are so spoiled, they got
home, and it was like 10 cents,or whatever. But I think that
(47:15):
there is, I don't want to, like,I'm not trying to generalize
here. But I have seen a bit of aresentment of this new crop of
individuals in our society, whomay never have the opportunity
to buy a house, and they neverhave an opportunity to do some
of the things that were privy tothese old, getting older
generation, right. And that setsthe table, I think, for
(47:38):
potential abuse of that. I'm notsaying it's happening in a rapid
fashion, but people there's adesperation there. Like in terms
of like, Okay, this is the oldcohort, and they had a good and
they may have, like you said,they've had a longer time to
kind of have a certainportfolio. And it could set the
(47:59):
stage for them being vulnerableto, you know, unfortunately, a
little more desperation from themillennials, or from, you know,
younger generations as well. I'mnot saying it's happening
everywhere, but I have seen ithappen. And so that's an
interesting societal setup,because even within a couple
generations, we have hugedisparity in opportunity. So
(48:22):
something doesn't get alwaystalked about, right. So I think
that if you're looking at signsof, you know, as an individual,
if you're going through this,and you're wondering, you know,
am I am I losing my some of mycapacity here. Some of the
subtle signs are things likepredicting people's names. So,
(48:42):
you know, people within yourfamily, especially for getting
routes that you drive that younormally you know, to sort of,
you might be driving all thesudden you find yourself in a
completely differentenvironment. Those are subtle
signs. Interestingly,depression, anxiety, sometimes
somebody comes in, and let's say70 Plus, and it's their first
(49:03):
episode of like, mentalbreakdown, I guess people would
call that it doesn't add upbecause they never had that
before. I've seen that be aharbinger of potentially
cognitive disorder that's in thewaiting. So if those type of
things are happening, then youmay want to get your memory
(49:24):
checked up their memory clinics,you may want to talk to your
first your family doctor and seewhat's happening. And because
that the worst thing, I think,is not to be prepared, and then
and then to have like, that kindof breakdown, and like I was
saying earlier, the tablesalready set for this kind of
dynamic of there's a sort of,there's going to be a debacle
(49:47):
potentially, if especially ifthe younger generation artists
fortuitous.
Preet Banerjee (49:53):
I think the last thing I want to end off with is,
you know, maybe on a morepositive note. Yes. For for
people who are out there rightnow they're, they're trucking
along. They're stressed, theremight be anxiety, there's
uncertainty, there's burnout.
It's chronic. Yeah. And I knowyou focus on wellness, what do
you recommend to people to say,Hey, listen, you know, if
(50:15):
there's one thing you can focuson to put yourself in a better
position to make betterdecisions, to to reduce, you
know, some of the stress anxietythat we're feeling, we're just
to promote, you know, mentalwellness, what are the things
that you see a lot of peoplejust they keep not doing even
though they know they'resupposed to do? What are some of
those things that that we reallyshould be doing to take, take
(50:38):
more care of our mentalwellness?
Dr. Ajmal Razmy (50:43):
Right? And yeah, by the way, May is Mental
Health Month. So I think it'sgood timing, you're asked to
separate for me that see,wellness sits on like three
major components of your life,which is sleep, exercise, and
nutrition. And I thinkeverything kind of stems out
(51:03):
from that. So we talked earlierabout making sure that you have
some sort of regular routine sothat you're getting proper
sleep, you're you don't want tobe exposed to all sorts of blue
light all throughout the night,that's going to throw off your
circadian pattern. soundssimple, but I think having
regulated sleep is sets thetable for your mental health, at
(51:26):
making time for regularexercise, and healthy nutrition
and not not talking in breach,but you know, making like
wholesome meals and taking thetime to do that maybe having fun
with it. Those those are thethree main components, I would
say, a sense of belonging. Ifyou look at resilience,
resiliency in general, and someof the core traits of
(51:48):
resiliency, a sense of belongingcommunity is so important. And
we can do that in all sorts ofways. Even if you're isolated by
yourself just sort of saying hito someone in the elevator, if
you live in a condo, checking inor neighbor, you know, socially
distance, I guess, but you know,saying hi people are people with
mass add on people or I say hito people all the time, they
(52:10):
look at me, like, Why are yousaying it? And so I think
whatever you can do, to havethat kind of sense of belonging
will help your resilience,having a growth perspective and
understanding that we will getthrough this, it will be
different, we may need all sortsof different things down the
line for different, you know,whether it's booster shots, or
(52:32):
whatever. But, you know, let'sgain a growth mindset and a
different perspective aboutwhere things are going to go
forward. accepting the factthat, you know, this is a tough
time 2% of our population isgoing to be hit hard. And we're
doing this because we care andas a species. That's pretty
(52:52):
cool, right? I mean, I don'tknow if you if you had a bunch
of lions, and they had thismethod, like talk about the
Coronavirus and said, well, 2%of us are going to die. So are
we going to like band togetherfor this? They may not. I think
as a species we have and we wantto care for one another and, and
we don't want to live knowingthat we did it. And so I think
(53:13):
that that perspective isimportant. We talked about
humor. So I think it's importantto still take time to, to to
have some joy to have somemoments of awe and appreciation
for what we're seeing. Andexperiencing even though it's
it's difficult. And lastly, Iguess to end on hope, right,
(53:34):
like to be hopeful for a betterfuture. And just like we're
talking about in terms oforganizational structure, you
know, the hybrid model might beawesome, and how do we
incorporate some of thepositives that we've gained out
of this pandemic? as tragic asit has been, with the hope for a
new corporate athlete for a newcorporate environment where we
(53:55):
can all Excel? I think, if youif you incorporate those
elements, then I think maybe thefuture's bright.
Preet Banerjee (54:03):
All right, well, we'll leave it there. But the
last part of every podcastnormally what I do is I give
every guest like a two minutecommercial. Would you would know
if you're a regular listener,but I guess you're not.
Dr. Ajmal Razmy (54:18):
I talked to you enough. Yeah,
Preet Banerjee (54:19):
no, I get your fill. Yeah. Okay. All right. So
So yeah, I mean, everyone getstoo many careers, but I don't
know what you would promotelike, hey, come see me in the
ER, I mean, you obviously wouldnot want that. But is there
anything that you do want to toplug?
Dr. Ajmal Razmy (54:38):
Well, I a couple things. So. You know, if
you're, I think I think ifyou're if you're cognizant about
your sleep and you're wondering,what is the quality of your
sleep and am I going through atough time? I happen to work at
sleep on the bay, which is areally fantastic sleep clinic
(54:59):
that looks at my Sleeping is butalso alertness and other facets
of your overall sleep function.
So, sleep on the bay.ca you cancheck that out. I think also
just in terms of a plug, I mean,like, like, let's give kudos to
Cleveland Clinic Canada for allthe amazing work that they've
done in terms of providinghealth care during this tough
(55:21):
time. Kudos to just a brand newhospital that really banded
around their community. You'renot just positions, the health
care workers, the the people inthe locker room, you know, Tim
Horton staff, everybody's sortof banded together and people
I've worked with, it's been sucha privilege to be with them. And
ultimately, you know, this isjust to help our community grow
(55:44):
and survive in this difficulttime. So, those are my only
plugs.
Preet Banerjee (56:00):
If you want more personal finance content, or you
have questions for me or topicsuggestions for the podcast, you
can follow me on Twitter orInstagram and ask away same
handle in both cases at PreetBanerjee, also have two YouTube
channels, you can subscribe tomy main channel, which covers
personal finance and investingtopics that are more global in
(56:23):
scope, and a Canadian specificchannel as well. That's it for
this episode. Thanks forlistening.
I've had many patients with bipolar disorder
(00:03):
during manic states, where youfeel lated you feel high, you
feel some grandiose thoughts.
And all of a sudden you have aFerrari F 12 in your, in your
driveway, right? And you knowthat. And maybe that's great if
you can afford it. But if a lotof people can't, and I've had,
I've had to write a couple ofletters to not Ferrari, but to
(00:23):
different companies saying that,Mr. or Mrs. So and So, purchased
this item under duress. And soyou know, it's a little bit of a
fight, but most most companiesunderstand, but not all.
Preet Banerjee (00:50):
In this episode, you're going to hear from a
psychiatrist on a number oftopics directly and tangentially
related to finances andfinancial decision making. Later
in the episode, we talk aboutsome financial behaviors under
acute mental distress, a numberof various pathways that lead to
hoarding behaviors, and more.
But we also discuss the effectsof chronic decision fatigue,
(01:12):
burnout, and Corona insomniathat almost everyone seems to be
experiencing. And I need topoint out that today's guest,
Dr. Agarwal, razzing me is oneof my very best friends. We
studied neuroscience togetherduring our undergraduate days at
U of T. And he continued on withhis master's in medical school,
whereas I, after my lastundergraduate exam, went on to
(01:35):
auto racing school as one does.
My parents are so proud.
This is mostly money and I'myour host Preet Banerjee, and
today's guest is one of my verybest friends Dr. Osmo rasmea.
(01:57):
He's a psychiatrist and mentalhealth specialist at Cleveland
Clinic Canada, with a backgroundin healthcare and a special
interest in sleep medicine andhospital administration. He is
currently a practicingpsychiatrist and head of service
for mental health at JosephBrant hospital with a focus on
acute care psychiatry. In thatrole, he is helping lead
(02:20):
Burlington his mental healthresponse to the novel
Coronavirus across the hospitaland Community Systems. He has
also served as a psychiatrymember of the consent and
capacity Board of Ontario, AajMa, my friend, welcome to the
show. prayed this is a dreamcome true. Thank you for having
that.
Okay, so I don't want to go wayback. So I think he's going to
(02:43):
maybe reveal a little bit ontoday's podcast. Before we start
that, I wanted to say why Iwanted to have you on this
podcast a couple of reasons. Oneis to talk about how the
pandemic has been affecting ourstates of mind, and how that
translates into performance notonly at work, but also with
making financial decisions. Andthis is something that you and I
have talked about quite a bitover the last, you know, 12
(03:06):
months, 18 months. And secondly,I wanted to ask you about areas
of personal finance, that don'treally get covered a lot in the
personal finance sphere thatmuch or at all. And that is when
financial decisions are madeunder acute mental crises, or
psychiatric disorders. So wewant to talk a little bit about
(03:27):
that, and your experiencedealing with some of the
financial aspects when it comesto you know, when you're dealing
with patients. Now, I alsowanted to actually start with
expressing gratitude to you andTina for the listeners, Tina's
his wife, also a physician, andall the colleagues that you work
with who are part of thehealthcare system battling
(03:48):
during this pandemic, because Iknow, it's been taking an
incredible tool, you know, noton just society as a whole, but
also everyone working inhealthcare. So thank you so much
for what you guys are doing. Ithink it's amazing. And my first
question is, how are you doing?
Dr. Ajmal Razmy (04:06):
Well, we're taking it day by day, truly is a
remarkable experience. I think,the way that I've wrapped my
head around just personally,this whole experience is just
thinking about this as aas a once in a lifetime,
hopefully, opportunity to toreally, you're in the middle of
history. Right. So I'll give youan example. At the hospital
(04:28):
where I work at St. Joseph'sJoseph Brant Hospital in
Burlington, you know, we areactually considering at this
point, redeployment ofphysicians to different areas of
the hospital they've neverworked with before. And so you
can take that, like, Oh my god,like, what am I going to do? I'm
(04:48):
a psychiatrist, how am I goingto like, you know, put an IV in
someone or I think you can kindof take the the growth mindset
of saying, Wow, I've now I'llprobably never be asked to do
this again. And I'm going to beworking with other people who
have a certain expertise. Andwe're going to work in teams.
And, you know, this is this isone of those like photo book
(05:09):
moments where you, you'll neveryou'll be able to tell this to
your, your grandkids, that wewere in this scenario, and we
How did we kind of bind togetherto make it through this. And,
for me, that's what keeps megoing is, is understanding the
historical context of wherewe're in, and also lining that
with some optimism that we willgrow to a different perspective
(05:31):
to a new world, and hopefully,to a better one, and that's
honestly, I take every day,
Preet Banerjee (05:38):
you know, I on one hand, I'm not surprised
that, you know, your perspectiveis, is has that sort of
framework, you know, you youbasically you're talking about
your coping strategy with this.
Incredible, like I said, once,hopefully once in a lifetime
scenario, but not everyone hasbeen able to sort of see it with
that same perspective. And Iknow, it's like been wearing a
(06:01):
lot of people that are includingphysicians, and I remember, we
were chatting because it was inthe news, you know, as a couple
of physicians who took their ownlives because of the stress and
dealing with what was going on.
And I remember that you werecalled by the media to talk
about what was going on. Becausenot only are you in the
healthcare system, you focus onpsychiatry, and how people
(06:24):
think. And so what might comenaturally for you, and in
creating these coping mechanismsand strategies to help get
through this for yourself, isforeign for a lot of other
people who are struggling rightnow. So I guess that's kind of
where I wanted to start is to,if you can go back to the
beginning of the pandemic, whichwas, you know, I guess, 14
(06:47):
months ago, but it feels like onone hand, yours, and at the
other time, it feels like, Idon't know, maybe it was just
like, it feels like it couldhave been just a couple months
ago, because time is so blurredtogether now. And I think that's
one of the first things thatpeople noticed was when we went
into lockdown. We didn't evenknow what day of the week it was
anymore. So can you walk usthrough what happened during the
(07:09):
onset of the pandemic, in termsof just our overall outlook on
our regular daily lives?
Dr. Ajmal Razmy (07:18):
Yeah, for sure.
And I think I mean, you likeFormula One? Right. So there's
been a lot of sort of shiftinginvolved. I think, you know,
there's been Sprint's andmarathons, and then sort of just
fatigue that we've we've beenoscillated amongst these waves.
I mean, I guess we're speakingfrom a Canadian perspective, but
certainly globally has beenexperienced differently based on
(07:39):
how the pandemic has impacteddifferent countries. But I think
initially, there was a lot ofuncertainty, a lot of fear.
Maybe a bit of denial. Oh, yeah,this is Yeah, I remember. I
mean, personally, I rememberjust thinking, well, this is
probably something localizesterrible, something localized
(08:00):
in, in, in Asia, and, you know,I don't just we've heard about
little things like this before,and maybe it'll be just
localized and, and hopefullycontained and dealt with, and
then as it was encroaching andimpacting Canada. Yeah, people
were like, what is this? What isthe nature of this, and we had
the backdrop of SARS, I guess,in the early 2000s, where that
(08:24):
was a very localized in withinthe hospital kind of condition,
and, you know, didn't seem toobad. In fact, I was a medical
student during that time, and itwas actually, to some medical
students, you know, it was agood learning experience, but
wasn't devastating, like us. Andso, I think we, we, we started
off in the sprint and this kindof chaos of anxiety and fear and
(08:48):
not knowing where this is goingto go. And then having that kind
of like that break of Okay,well, this is the first spring
and maybe that was it, is itgone? Is it not gone? You know,
quote unquote. And then I thinkthe subsequent waves have really
sort of like piggybacked on theinitial fears, and have gone
(09:09):
from the acute distress to moreof a chronic toll on people,
people's mental health. Andthat's what the data shows, too.
So we're in our third wave andin Canada, and the rates of
depression and anxiety are thehighest that they've ever been.
And in particular, some of therisk factors, the drivers of
(09:30):
that work from home, socialisolation, and a lack of
optimism, just because it wasyet another way. How many more
do we have to go through thatkind of thinking? It's been
devastating.
Preet Banerjee (09:45):
One of the things that we saw was the the
toilet paper hoarding. It wasmaking news around the world,
you would see pictures of justempty aisles at grocery stores.
Why did that happen? What whatwhat caused people to say, Hey,
this is the thing that I need tostock up on.
Dr. Ajmal Razmy (10:06):
While crises can bring out some interesting
human behavior, I think,remember, we're also like, I can
only speak locally in Canada,but we're also a country of, I
guess, immigrants in a way, likepeople who've made this a home
for themselves. And it really issuch a beautiful country in that
(10:26):
regard. But we also bring ourown traumas to this. I remember,
like my folks there from ofGhana, Stan, and and when this
was happening, they right awaygo back to like when they were
fleeing from Kabul, and it'slike, Okay, well, you know, you
better stock up and you betterbe prepared for whatever is
going to happen. And, and sopeople, I think there was a
(10:48):
cohort of individuals that thattheir previous traumas of
experience coming to thiscountry may have been triggered.
But I think there's just masshysteria, there's people with
uncertainty, people act in verystrange ways, financially and
otherwise, as we'll discuss. Butit's interesting that I think
that has become less and less ofan issue, as the waves of have
(11:11):
gone forward. But you might seean initial spike of it each
time, there's another way. Andthen it kind of dies off again.
Preet Banerjee (11:18):
And so you talked about how Initially, it
was more acute stress andanxiety, and now it's switched
to more of a chronic burden thatpeople are dealing with, that's
creating burnout. So can youtalk a little bit about burn,
because I know you've beenstudying, you know, the burnout
that's being exhibited now, aswell as what I think you call
(11:40):
Corona insomnia. And I havespoken anecdotally, to a number
of people who've had a number ofsleepless nights. And I'm
wondering, is there some kind ofcommonality? So let me know
what, what you've been studyingin, in the area of burnout and
how it affects us?
Dr. Ajmal Razmy (11:59):
For sure, I mean, it's, I'm also like, my
area of interest is preventativemental health and wellness. And
so within the hospital I workfor, for I, I'm their wellness
lead, I guess and so within thatbracket there, you know,
(12:19):
hundreds of physicians that, youknow, I am in some ways
responsible for for theirwellness and trying to help
address that. So for me, burnoutis is an absolute passion,
partly because, you know, I've,you know, like many people I've
been through too. But burnout,the problem with burnout is it's
like many terms in mentalhealth. It's kind of overused,
(12:40):
like what is depressed means ifyou had a bad day, or, you know,
Blue Jays loss, are you reallydepressed? I guess it depends.
But, you know, the, the terms inmental health can often get
blurred, because they become alittle bit too common in the
vernacular. But burnout is aterm that's been around for
decades. I the best researchdone on burnout, the highest
(13:05):
quality, I would say is byChristina maslach out of
Berkeley, who has studied thisfor since the 80s. And, and only
recently, the World HealthOrganization has identified
burnout as an actual condition.
So in their InternationalClassification of Diseases,
their latest version of 12 lovetheir 12th edition and 2019,
(13:28):
they came out with actuallydefining what burnout is about.
Interestingly, they classifyburnout as an occupational
phenomenon. So depending onwhich organization you're part
of, people may not like to usethe term burnout, because it may
reflect some sort of perceivedflaw by the organization to
address sort of a toxicenvironment, if you will. But
(13:51):
there are three sort of Cardinalcomponents of burnout. In no
particular order. The number onesort of, quote unquote symptom,
although it's not a it's not asymptom, it's part of a syndrome
is a exhaustion. So that tiesinto the cronyism, which we'll
talk about, but just feelinglike completely an utterly wiped
(14:13):
out. People have been there, butthis is sustained, right, every
day feeling the same way likethat. The second sort of
component is cynicism. theraising of the brow, the, you
know, absolute disregard, oralmost discontent, I guess, with
(14:34):
policymakers, whether it'sgovernment or your organization,
people work for etc. People wholay down the rules, just people
becoming increasingly cynical,if you find that's happening,
that's another component, andthen just not feeling effective.
Not feeling like you're doingyour job right. And I think at
some level, many of us, myselfincluded, you know, we Just the
(14:58):
nature of being sort of alphadriven, if you will, can have
these components and it's notone. It's not just the
exhaustion. It's not just thecynicism. It's not just feeling
ineffective. But it's a littlecomponent, a little hybrid of
all of these things, a Venndiagram, that if you have over a
sustained period of time, likelyyourself suffering from burnout,
(15:19):
the important point and Dr.
masstige very elegantly bringsus forth is that burnout is not
a me problem. But it's a weeproblem. It's something that's
endemic to the system that'sthat's built around you, much
(15:41):
like environmental toxins andstuff like that. And in
workplace it's, it's, it'ssomething that's endemic to the
the organizational structure.
And certainly, I would saybefore COVID-19, burnout was
rampid, in many differentorganizations, especially in
healthcare. But this is justsort of, I think, the COVID-19
is served as an accelerant toall of those problems related to
(16:05):
burnout.
Preet Banerjee (16:09):
When it comes to the burnout that's being
exhibited by people, myunderstanding is that people
with kids, single parents, twoparent households, when you have
kids, it seems like they're juston a totally different, like
quantum level, because they'vehad to deal with what do we do
with the kids? What are theschools doing? What is the
(16:30):
government saying? The rules arefor, you know, going back to
school online learning ordaycares open? What's open,
what's closed? And why are wegetting these messages with, you
know, like, 24 hours notice,juggling that with your work and
making concessions. Do you haveany insights into you know,
what, what categories of peopleare being affected most right
(16:51):
now? With respect to burnout?
Dr. Ajmal Razmy (16:54):
Yeah, for sure.
I mean, it's interesting, right?
Everybody experiences at adifferent level? I would say the
millennial, the millennials alsohave a different type of
burnout. You know?
Preet Banerjee (17:09):
Oh, tell me more about that. What do you mean by
a different type of burnout?
Dr. Ajmal Razmy (17:13):
Well, this is just the way I see it. But I
mean, you can imagine people whoare sort of early on in the
career just like maybe you justlanded your, your job with the
organization of your dreams. Andyou're like, Okay, I want to
start where my mentors and boom,everyone's like, gone virtually,
right. There's none of the whathappened to the, you know, sort
of like shadowing along withwith some of these more senior
(17:38):
vets within your organization,and just feeling that sense of
like, not necessarily belonging,which is like an important
component of resilience, forexample. So I think millennials
feel that kind of isolation,maybe devalued, a little bit. I
think there's been a lot of talkabout the parents and people who
(17:58):
have kids, and that kind oflike, hug a little bit of the
sympathy around burnout, andrightfully so, as a parent,
like, it's, it's true, but Ithink that the millennials,
themselves, if you know, forthose that are single and, and
or, you know, with our children,they've also had a very
(18:20):
different struggle, and I don'twant to minimize that. But when
you look at the, the data inhealthcare, so we look at
healthcare industry, it's beenthe, the Gen X population that
suffered a lot kind of TheInbetweeners, right. So you're
kind of like dealing with like,aging parents, and you're
dealing with like, you know,breastfeeding or whatever you're
(18:42):
dealing with. And so you'reright in the middle there. And I
think, for how that's that'sproved to be a sticky point.
Depending on the way yourorganization structured, it's
important to look at thesedifferent categories and
understand and appreciate thateveryone's impacted but just
differently, right?
Preet Banerjee (19:01):
Yeah, cuz I would, one of the things that
I've noticed as well is, youknow, if you're younger, and
you've been living on your own,maybe you don't have a life
partner, yet, you've gotisolation and being isolated
with everything that's happeningright now, is a different sort
of stress than the stress of youknow, having family and kids and
dealing with, you know, overloada different sense, because you
(19:24):
can say, well,
Dr. Ajmal Razmy (19:25):
so that the person who's isolated can say to
the person who's not saying thatwhat you have your husband and
you're not alone, and blah,blah, blah, and then you know,
that person, that person Yeah,
Preet Banerjee (19:36):
I've got my husband and I'm not alone.
Dr. Ajmal Razmy (19:41):
Oh, yeah. It's hilarious, but it's, it's, it's
hilarious to talk about, butit's certainly very stressful to
experience. Yeah,
Preet Banerjee (19:47):
well, yeah. I mean, you and I, obviously,
we're friends and we joke aroundall the time. So there's going
to be a bit of levity here, butthat is also part of a coping
strategy for a lot of people aswell finding, trying to find the
humor where you can becausethere's so many things Just
bring us down right now. Yeah.
So let's talk. I think this isreally a good segue, because
we've talked about thesedifferent sort of situations,
you know, families, individualsliving in isolation. And then
(20:10):
there's been, there's been thisapparent exodus from city
centers into, you know, therural areas, and people are
looking at moving to, you know,the East Coast. And there's,
there's just people migrating,apparently, to the city centers,
people don't know if that'sgoing to be long lasting or not,
but what can you What can youtalk about in terms of why this
(20:31):
is happening, and what you'vebeen what you've been seeing?
Dr. Ajmal Razmy (20:38):
Yeah, I, again, full disclosure, I'm not a
financial expert, by any means.
But I think, you know, justbehavioral sort of analysis
here, the reptilian brain ispowerful man, it can really do
it, you know, the tail does wagthe dog, in many cases here. And
I think that when people areunder distress, and there's a
(21:00):
lot of uncertainty, you know,decision making in financial
decision making just part ofthat people can make interesting
choices. I, you know, there'sI've treated some of my patients
that have moved on from, youknow, urban centers, to more
quieter settings. And, you know,some, some are very happy with
(21:22):
that, and others are saying,Hey, you know, what, what did I
do this board is all of all thatI have around me a couple of Tim
Hortons, and I don't know, Imiss Toronto, or I miss the
urban life. But when I go backthere, everyone's wearing masks,
and we get doing so but butagain, that's a very narrow
perspective. Right? So to methat's speaking and those
examples of how during fight orflight kind of thinking,
(21:44):
people's decisions are become alittle bit skewed. And I think,
from from what I understandabout financial decision making
as well, the motions take a bigpart, and they kind of like,
they actually take over thecognitive processes and many
times, right, and so I thinkthat's, it's probably a little
bit of that I would anticipate,from a mental health perspective
(22:06):
and from like, like, a brainscience perspective, that
that'll probably course correcta little bit as time goes on.
Preet Banerjee (22:16):
Yeah. And I think tied to that, we've also
seen pretty strong increases inhousing prices. And we're
seeing, you know, incrediblebidding wars, we're hearing
stories about houses going upfor sale, and there'll be like
49 competing bids, people arebidding 400,000 over asking, and
people are talking about FOMO,the fear of missing out on
getting in on a housing. And soit's causing a lot of people to
(22:37):
really stretch themselves thin.
And we're not talking aboutpeople would show up in the ER,
in some kind of, you know, acuteepisode of mental distress. This
is like, you know, a lot ofpeople, what can you What can
you say about the fear ofmissing out or keeping up with
the Joneses? how prevalent isthat in people? And how much of
an impact does that have on ourfinancial decision making?
Dr. Ajmal Razmy (22:58):
I think it's huge. I see it all the time.
I've had I've had a handful ofpatients over over the course of
this winter, that you talk aboutFOMO. But they're also kind of
what is called buyer's remorse,as well. And they were in
(23:20):
situations where they were outbidding, and it became personal,
on a property. And they ended uppaying way more than they wanted
to, but they just wanted toclose it. They didn't want to
give it up at some point. AndI'm sure many, many of the
listeners have been in thosescenarios. And it's almost like
when you're in that zone, it'slike you're playing roulette, or
you're at a table in Vegas, andyou just can't stop. So it's an
(23:44):
interesting phenomenon. And butthere's something innate about
wanting once you're kind of likecommitted this kind of fear of
losing out on on what you thinkis right. And and people, I
guess it's evident right now,especially in, in Ontario, I
guess, just people really payingthrough the roof. And it's
(24:07):
interesting, it's going to beinteresting to see what people
think six months down the roadwhen things kind of swing in
different directions.
Preet Banerjee (24:13):
One last thing I want to talk to you about the
pandemic before we change gearsa little bit, and that has to do
with this Corona insomnia. So Ipersonally have had a number of
nights where I am just awake allnight long. And you know, I keep
on maybe rationalizing to myselflike I have a such an unusual
schedule. You know, I don't haveto be anywhere at 9am in the
(24:35):
morning, whether it's online orand I don't go anywhere anymore.
Every now and then I'll do amorning radio show, which I have
to get up at 5am to do some prepfor occasional do morning TV
shows maybe once every two weekskind of thing. But other than
that, you know, I have no realset schedule. So I thought well,
maybe it's just because youknow, I go to bed and wake up at
(24:56):
totally different times all thetime. And my body's just like
Yo, what are you doing? Keepyour mind. But I think I'm not
alone. Because I've been hearingfrom a lot of people that
they're just up all night, andit's something that they've
never experienced before. So Iknow you, you and I have talked
a little bit, you've talkedabout something called Corona
insomnia. So what is that?
Dr. Ajmal Razmy (25:18):
Yeah, so I'll wear my Sleep Medicine Hat. Now,
but Corona insomnia. I wish Icoined the term myself. But it's
something that's used sort of inthe sleep medicine world to
reflect the sleep disturbancethat's been sort of triggered.
During COVID-19. It's been seenon all across different sleep
research centers. throughoutNorth America, and globally,
(25:43):
actually, some of the data justcoming through now. I mean,
insomnia is a very commoncondition. If we think of sleep
in general, like if we take astep back, sleep has a
homeostatic function. So like,basically, as the day goes on,
there's this drive for sleepthat builds. And it also,
there's also a circadianelement, which is based on light
in training, our sleep patternsand, and so if you think of,
(26:07):
just from that mechanisticperspective, you think about the
pandemics done in terms ofpeople working from home and
working at different hours andmaybe not taking breaks, and
having all this blue, blue lightthat's they're exposed to
through their devices allthroughout the the night,
potentially, it's no wonder thatboth the homeostatic and
(26:29):
circadian functions of sleep arekind of like offset. And so
we're seeing a sleep researcherseeing both an increase in
insomnia, so people havingdifficulty either falling or
staying asleep, and alsohypersomnia, where some people
just because they have noschedule, or like going to bed
at like, midnight, we're notwaking up till noon. So
Preet Banerjee (26:53):
yeah, there's some nights I get up, I was
like, I just cannot get out ofbed. And
Dr. Ajmal Razmy (26:58):
it speaks to how important I think routine
is. And it also speaks to thatfunction that work actually
plays, you know, I think interms of having, you know, the,
the kind of like, if you thinkof how many hours are you
actually productive at work now,you're probably an exception,
you I'm sure you have a veryproductive all the time,
Preet Banerjee (27:15):
two hours, tops.
Dr. Ajmal Razmy (27:16):
Yeah, I was saying for myself, maybe half an
hour. If I'm good, and but it'sall the other stuff, it's all
the other scaffolding of likegetting up, hopefully showering
once in a while driving to work,you know, saying hi to Tim
Hortons person, or whatever, orif you work at Tim Hortons,
saying hi to your colleagues.
And then coming back, you know,and and so all of those things,
(27:38):
that that what I call thescaffolding of work is is
stripped away. And so you know,what you're left with is, you
know, for a lot of people, Idon't you find, but work from
home has actually increaseddemands on productivity, I think
people are actually working moremuch more than when they were
going into their office spaces.
Preet Banerjee (28:03):
Yeah, and we talked about, you know, the, all
the things these demarcations oftime, you know, that you have
with a routine that is justblown out the window, when you
know, when the restrictionstarted and work from home for a
lot of people. Because Iremember back when I did used
to, you know, go to an officeand work, everything was such a
(28:26):
routine. And if I wanted to workout, I would have to plan around
my work schedule, say, Alright,if I'm going to work out, I got
to get up at five, get to thegym at 530. I got to get home
shower, and then make it towork, leave by a certain time.
You have your breaks at acertain time of day, you have
your lunch break, maybe you havethe same people that you hang
out with at lunch, you got yourafternoon, break, the end of the
(28:48):
day, you've got some time todecompress on the way home and
change gears from work life tohome life. And that all changed
when I you know before thepandemic when I went, you know,
completely self employed Justwherever myself, I find it was
harder to get a lot of thingsdone unless I reinstituted some
kind of routine or schedule intomy life. Otherwise, it was
always I could do it any timebecause I have no Boss, I could
(29:10):
just fit in in whatever I want.
And that would never fit it inunless I put it into my
schedule. And then now with apandemic, I think everyone is
sort of experiencing all thosethings that we had that that was
our routine, our scaffolding, ifyou will, is gone, and
everything is blurred together,you're at home, you're working
from home and your kids are homeand they're like, hey, I need
(29:30):
lunch or, you know, we need toget out and get some exercise.
And so you'd be working and thenthe next minute you're, you
know, home life, and then you'reright back to work life. And so
the there was no there was nochange from home life to work
life. It's all sort of blendedtogether. And I think that that
has taken quite a bit of a tool.
(29:52):
Now we've talked a lot about,you know, the burdens on people
whether it be through burnoutthrough disturbing Isn't sleep?
How do these things affect ourability to make financial
decisions?
Dr. Ajmal Razmy (30:07):
tremendously. I just want to make one quick
point. So although the pandemicis kind of like hit our
workplace structure, like ameteorite and kind of blowing
things up, I think it's alsouncovered some other like
positives, too, right? Like,there's lots of people actually
like the flexibility and maybedon't always want to commute
maybe there's maybe that has abenefit in terms of our own
(30:29):
carbon footprint as well. And,you know, what are some of the,
I guess, to when I speak to CEOsof companies we talk about?
Like, what are some of theopportunities to really take
some of the pluses that thepandemic has served for the
average worker or for themanager, middle management, or
even CEOs? Like how do we likerestructure things for the new
(30:52):
corporate athlete to reallysurvive in this new terrain? I
think there are a number ofpositives. I mean, I've enjoyed,
you know, having the flexibilityto work out more, you know,
whether it's using the bike orwhatever. And, and sometimes
actually seeing my kids a littlemore because they happen to be
home too, right. So that it'snot all doom and gloom. And I
(31:13):
know, you're not saying that atall. But I think how do we how
do we take some of those thingsand work in this hybrid
structure going forward? So thatthat is not all bad? Right? So I
do think those are options. Ithink a lot of people are
looking at that. And I'm excitedto see what the new corporate
landscape will be.
Preet Banerjee (31:32):
And do you have Do you have, cuz I know you work
with corporations to talk aboutstuff like this, because this
is, you know, productivity iscore to many organizations. And
and I agree with you, 100%, Ithink a lot of people's eyes
have been opened to, hey,there's a different way of
working. And that's part of whyI would never go back to to work
(31:52):
for a big organization in anoffice commuting to it, I could,
once you've tasted what it'slike not to have to commute. For
me, I don't think I could evergo back. But I think a lot more
people are realizing, hey, notonly is it possible, because
they were forced to do it. Butit turns out that there are some
benefits to it. And I think somepeople say, hey, when things get
back to whatever the new normalis, maybe there will be a
(32:14):
different split. So what haveyou been hearing from from CEOs
that you consult with? about,you know, organizations and Nv
structures? What do you what doyou think is going to happen?
Dr. Ajmal Razmy (32:25):
So what I'm really encouraged about is, and
this is some of the work I dothrough Cleveland Clinic Canada
is, is the pandemic has given anopportunity for corporations to
also look at the work lifebalance in a true way. And
really looking at what is theROI on mental health and well
(32:48):
being. And so adapting to thehybrid lifestyle in terms of
work, but also going forward interms of how that's going to
impact the organization and howthings are structured. It's
actually put wellness at thetable of conversation, not just
lip service. And I think themessage that I try to send out
(33:10):
when I'm when I'm doing some ofthese sort of engagement points
is how do we win with beta. Andwhat I mean by that is, there's
been a cost with always havingsort of alpha producers within
your organization in terms of gogetting and not stopping and
going, you know, 110 miles anhour every day, in terms of the
(33:32):
results and impact on burnout.
And so when I say winning withbeta, I mean, adapting whether
it's a hybrid, corporatelifestyle, whether it's making
more time for breaks, whetherit's making more time for
exercise and nutrition andmindfulness. Are you actually in
the long run more successful asa beta organization? Or do you
(33:53):
want to have a bunch of alphathoroughbreds in your corner?
It's it's an interesting debate.
I'm not saying one is right orthe other. But I think there are
some benefits to considering thebeta approach.
Preet Banerjee (34:06):
That's, that's interesting. For my listeners
who are more financiallyfocused. Alpha and Beta mean
totally different things in theworld of fine. Yeah. However,
winning with beta is actuallykind of an overarching theme in
the financial world as well.
It's associated with indexinvesting anyways, I don't want
to nerd nerd out on that toomuch. I want to go back to a
question that asked you butbefore we do that, Cleveland
(34:28):
Clinic, this is Oh, I don't knowif you've been to other
Cleveland Clinic locationsaround the world. When I was
working in Abu Dhabi once thehotel room that I was staying
in, right across, there's Iguess it was a manmade River.
There's the Cleveland Clinic,Abu Dhabi. And this place was
huge, and at night, it had likethis glowing lattice all around.
(34:53):
It looked like a club likehonestly, I thought, like, you
go there to get treated or yougo there for ball. service like
it was insane. Have you seenthat one?
Dr. Ajmal Razmy (35:04):
I haven't been there. But I've seen it. It's
absolutely spectacular. Yes.
Preet Banerjee (35:16):
The conversation with Dr. Arch Mel rasbian
continues in just a minute. Butfirst, a few thank yous to
listeners who left comments onApple podcasts. jtb. Good. Thank
you for your very kind comments.
And Rajiv, who goes by themoniker, Surrey old timer. Thank
you, as well for leaving a kindof review. And thank you to
everyone who leaves ratings andcomments on Apple podcasts. I
(35:38):
appreciate them. And I do readthem all. And now, back to the
conversation with Dr. octanol.
resume.
(36:00):
Let's let's go back to thequestion I asked you about the
impacts of burnout, and cronyinsomnia on people's financial
decision making, you said it wastremendous. But tell me more
about that.
Dr. Ajmal Razmy (36:10):
What I'm seeing is some more desperation, in
terms of like narrow, like anarrow mindset in terms of like,
you know, what is what are thelong term forecast looking here,
like your Do we need to get outof urban centers and buy rural,
for example, we already spokeabout that. What about, you
(36:30):
know, investing in things thatyou would normally wouldn't do,
right, making, like decisionpoints that just don't make
sense. And you see itfinancially, but you also see
it, you know, in terms ofeveryday decision making with
with some of the people thatthat I see on an on a regular
basis, and it has liketremendous impact on their well
(36:50):
being. An example is, and thisis not a financial decision
point. But it's in terms ofcoping, right. Some people buy
things to cope. I mean, I'm surelike, how many Amazon boxes do
people have people sort ofcollected and have to get rid
of, right? It's like a wholebusiness to get rid of these
boxes? And I would say, that'slike, why did I buy those? You
know, why did I buy those, like,eight t shirts that are all the
(37:13):
same? They don't fit me? Youknow, and they come into these
boxes, and you're like, what amI doing with all this stuff? But
I think there is some some ofthat happening as well. But it's
interesting, because I thinkwhen you get into that kind of
state of being overwhelmed,being ineffective, feeling
cynical, it definitely impactsyour cognitive abilities to make
(37:37):
sound decisions. And I've seenthat trickle down in terms of
financial decision making aswell. Yeah.
Preet Banerjee (37:43):
Let's shift gears a little bit. And I want
to talk to you about some of theextreme financial situations
that you've, you've seen yourpatients present with. And you
end to put it into context. Youknow, when when you're dealing
with people you're not dealingwith, with people who sort of
(38:05):
say, hey, I need to talk tosomeone, I got some problems to
work out, you know, let me finda therapist to work with. You're
dealing with people who arelike, facing trauma, like when
they present to you like, like,things are dire. Right. So can
you can you sort of talk aboutsome of the extreme situations
that that you see, in terms ofthe financial aspects?
Dr. Ajmal Razmy (38:27):
Yeah, for sure.
I mean, whenever So, in general,when I asked my patients
questions about like, what whatare your main stressors in your
life right now? Certainly, Imean, right now, COVID is at the
top, but it's alwaysrelationships and money are the
top two things that come outalmost every time I assess
(38:47):
somebody. And and so I thinkthat's, that tells you about the
indelible kind of like, arelationship between money
matters and mind matters and howhow the two, sort of toggle one
another and, you know, there's anumber of different mental
health conditions that impactthat, I mean, classic examples
(39:09):
or not, I've had many patientswith bipolar disorder. During
manic states, where you feellated you feel high, you feel
some grandiose thoughts, and allof a sudden you have a Ferrari F
12 in your, in your driveway,right? And you know, that and
maybe that's great if you canafford it, but if a lot of
(39:32):
people can't, and I've had, I'vehad to write a couple of letters
to not Ferrari, but to differentcompanies saying that, Mr. or
Mrs. So and So, purchased thisitem under duress. And so you
know, it's a little bit of afight, but most most companies
understand, but not all, and soand the financial toll that,
(39:55):
like bipolar, surfing, take on afan. Emily, for example is
devastating, right. Andsometimes people never recover.
Certainly, there's cases ofpeople with dementia. And, you
know, maybe their financialcapacity hasn't been
established. And they'reselling, I've been on cases
(40:18):
where they've sold their entireestates to random strangers that
they've just met, for example.
And so that all of the, youknow, working back through that
kind of messy situation withfamilies, etc. Or you have
family members trying to takeadvantage of people whose
faculties are, are weathering,unfortunately, I want to make a
(40:40):
point A lot of people withmental health and mental illness
in general make great financialdecisions as well. But it's just
that finances relationships arevery, very fragile when your
mental health is in duress. Andright now, with with the
pandemic, going from acute tochronic, we're seeing that
(41:01):
impacted in various ways.
Preet Banerjee (41:04):
I actually had a situation maybe about a year
ago, someone who reached out tome, I hadn't spoken to them in a
couple of years. And they werelooking for help to rebuild
their, their financial situationin general, because they were
bipolar. And during a period ofmania, they had gone on an
(41:24):
extreme spending spree. And sothey just bought anything and
everything in sight. They justfelt good and felt like, you
know, they were invincible. Andthen it caught up with them,
because, you know, eventuallyall their credit cards got maxed
out. And and then I guess, Idon't know the details of what
happened later. But I'm assumingthe mania ended, and then
(41:45):
reality sort of set in, and theyhad to dig themselves out of a
big financial hole. And so thesethings can become quite extreme.
Another area that I know gets alot of attention, and and I
think sometimes is almostglorified, at least for
television purposes, ishoarding, like some of the most
(42:05):
popular shows are coveringpeople who hoard things, right.
And people gawk at them andwhatnot, but it's really, it's
really quite, you know,disturbing, and I really feel
for them, because from what Iunderstand, it's not something
that they just say, Hey, youknow, I think I'll just collect
stuff. There's there's somethingmore behind it. Can you talk
about what is sort of, like theunderlying factors with extreme
(42:30):
hoarding?
Dr. Ajmal Razmy (42:32):
Well, I mean hoarding is, I mean, that's,
there's different sort ofpathways to that. One pathway is
almost through obsessivecompulsive disorder. And there's
certain obsessions about likecollecting things and not
letting them go, for example, orhaving a fear that if you were
to let something go, somethingbad would happen to somebody
(42:53):
else. And, and so that's from ansort of an anxiety spectrum
issue where people hoard,oftentimes, people with dementia
or when they start havingcognitive disorders, for various
reasons are just like, not ableto process why they're there
keeping on to certain things.
And so basically, it's aweathering of your brain in that
(43:16):
condition. So there aredifferent pathways to hoarding.
Yeah, it's, it's, it does breakyour heart, when you hear about
that. It does affect a lot ofpeople, I would say most of the
people that I've ever treatedwith with hoarding behavior were
more from the cognitive disorderspectrum, usually, usually is a
sign of like some sort ofAlzheimer disease, a
neurodegenerative condition likethat, that's where I've seen it
(43:38):
mostly. But again, often notseen. And you may not even know,
right, so somebody in your bankis just coming in walking home.
And if you ever go to theirhouse, you see that there's a
sandwich on the table that wasthere from, you know, last
Christmas, and it's just there.
So I think there's a number ofchronic illnesses, that mental
(44:03):
health illnesses that can impactpeople's financial decision
making capacity. Most of thepeople actually you're not in
that state. And I think thatwithin the pandemic, there's
sort of like a lighter sort ofinflection points related to
this, but you're seeing it indifferent ways. I think mostly
from sort of an anxietyperspective where people are,
(44:24):
are making decisions that theynormally wouldn't
Preet Banerjee (44:28):
want to ask you about your your work on the
consenting capacity Board ofOntario. First of all, can you
explain what that board is?
Dr. Ajmal Razmy (44:38):
Yeah, so it's basically a a multi disciplinary
board, which consists of ausually a mental health or
psychiatry member, a lawyermember and a community member
that helped make decisions wherepeople aren't usually where
(45:01):
people are related to theircapacity to make decision
makings, if they've been ifthey've suffered from a mental
illness, or their consent tocertain treatments, for example,
or being in hospital, againsttheir will, for example. So
yeah, it's my work that I didwith the board is really quite
(45:26):
quite a privilege to be able towork with with them. And they do
great advocacy for peoplesuffering from mental health
issues.
Preet Banerjee (45:35):
And, you know, this, this idea of consenting
capacity is something that'sbecoming a bigger issue in the
financial services. Soregulators are now putting a lot
more attention, they haven'tignored it before, but they're
putting a lot more attention topeople who are older and may not
be able to make decisions intheir own best interests due to
(45:57):
whatever dementia orAlzheimer's, whatever could be
affecting their ability to makedecisions, especially when
you're older, you know, maybeyou've got a bigger portfolio,
you've had more time toaccumulate money, it's more
people want to take advantage ofyou. Or you have family members
(46:17):
who are trying to take advantageof you. And so they may have
decided a while ago, I'm goingto put someone else in charge of
these decisions. And sometimesthey may not make decisions that
are in the best interest of thatperson who's assigned them that
power. So what are the generalthings to look for? And this is
a tough one to sort of, youknow, provide advice to people
(46:40):
on but you know, if you've gotpeople around you, or you're
worried about your own capacityto make decisions, what are the
signs that someone doesn't havethe capacity to make their own
decisions?
Dr. Ajmal Razmy (46:54):
Right? Well, just if I could take a step back
to I think what's interestingfrom a societal perspective is
if you ask millennials, how theyfeel about baby boomers, right?
They're like, Oh, man, thoseguys are so spoiled, they got
home, and it was like 10 cents,or whatever. But I think that
(47:15):
there is, I don't want to, like,I'm not trying to generalize
here. But I have seen a bit of aresentment of this new crop of
individuals in our society, whomay never have the opportunity
to buy a house, and they neverhave an opportunity to do some
of the things that were privy tothese old, getting older
generation, right. And that setsthe table, I think, for
(47:38):
potential abuse of that. I'm notsaying it's happening in a rapid
fashion, but people there's adesperation there. Like in terms
of like, Okay, this is the oldcohort, and they had a good and
they may have, like you said,they've had a longer time to
kind of have a certainportfolio. And it could set the
(47:59):
stage for them being vulnerableto, you know, unfortunately, a
little more desperation from themillennials, or from, you know,
younger generations as well. I'mnot saying it's happening
everywhere, but I have seen ithappen. And so that's an
interesting societal setup,because even within a couple
generations, we have hugedisparity in opportunity. So
(48:22):
something doesn't get alwaystalked about, right. So I think
that if you're looking at signsof, you know, as an individual,
if you're going through this,and you're wondering, you know,
am I am I losing my some of mycapacity here. Some of the
subtle signs are things likepredicting people's names. So,
(48:42):
you know, people within yourfamily, especially for getting
routes that you drive that younormally you know, to sort of,
you might be driving all thesudden you find yourself in a
completely differentenvironment. Those are subtle
signs. Interestingly,depression, anxiety, sometimes
somebody comes in, and let's say70 Plus, and it's their first
(49:03):
episode of like, mentalbreakdown, I guess people would
call that it doesn't add upbecause they never had that
before. I've seen that be aharbinger of potentially
cognitive disorder that's in thewaiting. So if those type of
things are happening, then youmay want to get your memory
(49:24):
checked up their memory clinics,you may want to talk to your
first your family doctor and seewhat's happening. And because
that the worst thing, I think,is not to be prepared, and then
and then to have like, that kindof breakdown, and like I was
saying earlier, the tablesalready set for this kind of
dynamic of there's a sort of,there's going to be a debacle
(49:47):
potentially, if especially ifthe younger generation artists
fortuitous.
Preet Banerjee (49:53):
I think the last thing I want to end off with is,
you know, maybe on a morepositive note. Yes. For for
people who are out there rightnow they're, they're trucking
along. They're stressed, theremight be anxiety, there's
uncertainty, there's burnout.
It's chronic. Yeah. And I knowyou focus on wellness, what do
you recommend to people to say,Hey, listen, you know, if
(50:15):
there's one thing you can focuson to put yourself in a better
position to make betterdecisions, to to reduce, you
know, some of the stress anxietythat we're feeling, we're just
to promote, you know, mentalwellness, what are the things
that you see a lot of peoplejust they keep not doing even
though they know they'resupposed to do? What are some of
those things that that we reallyshould be doing to take, take
(50:38):
more care of our mentalwellness?
Dr. Ajmal Razmy (50:43):
Right? And yeah, by the way, May is Mental
Health Month. So I think it'sgood timing, you're asked to
separate for me that see,wellness sits on like three
major components of your life,which is sleep, exercise, and
nutrition. And I thinkeverything kind of stems out
(51:03):
from that. So we talked earlierabout making sure that you have
some sort of regular routine sothat you're getting proper
sleep, you're you don't want tobe exposed to all sorts of blue
light all throughout the night,that's going to throw off your
circadian pattern. soundssimple, but I think having
regulated sleep is sets thetable for your mental health, at
(51:26):
making time for regularexercise, and healthy nutrition
and not not talking in breach,but you know, making like
wholesome meals and taking thetime to do that maybe having fun
with it. Those those are thethree main components, I would
say, a sense of belonging. Ifyou look at resilience,
resiliency in general, and someof the core traits of
(51:48):
resiliency, a sense of belongingcommunity is so important. And
we can do that in all sorts ofways. Even if you're isolated by
yourself just sort of saying hito someone in the elevator, if
you live in a condo, checking inor neighbor, you know, socially
distance, I guess, but you know,saying hi people are people with
mass add on people or I say hito people all the time, they
(52:10):
look at me, like, Why are yousaying it? And so I think
whatever you can do, to havethat kind of sense of belonging
will help your resilience,having a growth perspective and
understanding that we will getthrough this, it will be
different, we may need all sortsof different things down the
line for different, you know,whether it's booster shots, or
(52:32):
whatever. But, you know, let'sgain a growth mindset and a
different perspective aboutwhere things are going to go
forward. accepting the factthat, you know, this is a tough
time 2% of our population isgoing to be hit hard. And we're
doing this because we care andas a species. That's pretty
(52:52):
cool, right? I mean, I don'tknow if you if you had a bunch
of lions, and they had thismethod, like talk about the
Coronavirus and said, well, 2%of us are going to die. So are
we going to like band togetherfor this? They may not. I think
as a species we have and we wantto care for one another and, and
we don't want to live knowingthat we did it. And so I think
(53:13):
that that perspective isimportant. We talked about
humor. So I think it's importantto still take time to, to to
have some joy to have somemoments of awe and appreciation
for what we're seeing. Andexperiencing even though it's
it's difficult. And lastly, Iguess to end on hope, right,
(53:34):
like to be hopeful for a betterfuture. And just like we're
talking about in terms oforganizational structure, you
know, the hybrid model might beawesome, and how do we
incorporate some of thepositives that we've gained out
of this pandemic? as tragic asit has been, with the hope for a
new corporate athlete for a newcorporate environment where we
(53:55):
can all Excel? I think, if youif you incorporate those
elements, then I think maybe thefuture's bright.
Preet Banerjee (54:03):
All right, well, we'll leave it there. But the
last part of every podcastnormally what I do is I give
every guest like a two minutecommercial. Would you would know
if you're a regular listener,but I guess you're not.
Dr. Ajmal Razmy (54:18):
I talked to you enough. Yeah,
Preet Banerjee (54:19):
no, I get your fill. Yeah. Okay. All right. So
So yeah, I mean, everyone getstoo many careers, but I don't
know what you would promotelike, hey, come see me in the
ER, I mean, you obviously wouldnot want that. But is there
anything that you do want to toplug?
Dr. Ajmal Razmy (54:38):
Well, I a couple things. So. You know, if
you're, I think I think ifyou're if you're cognizant about
your sleep and you're wondering,what is the quality of your
sleep and am I going through atough time? I happen to work at
sleep on the bay, which is areally fantastic sleep clinic
(54:59):
that looks at my Sleeping is butalso alertness and other facets
of your overall sleep function.
So, sleep on the bay.ca you cancheck that out. I think also
just in terms of a plug, I mean,like, like, let's give kudos to
Cleveland Clinic Canada for allthe amazing work that they've
done in terms of providinghealth care during this tough
(55:21):
time. Kudos to just a brand newhospital that really banded
around their community. You'renot just positions, the health
care workers, the the people inthe locker room, you know, Tim
Horton staff, everybody's sortof banded together and people
I've worked with, it's been sucha privilege to be with them. And
ultimately, you know, this isjust to help our community grow
(55:44):
and survive in this difficulttime. So, those are my only
plugs.
Preet Banerjee (56:00):
If you want more personal finance content, or you
have questions for me or topicsuggestions for the podcast, you
can follow me on Twitter orInstagram and ask away same
handle in both cases at PreetBanerjee, also have two YouTube
channels, you can subscribe tomy main channel, which covers
personal finance and investingtopics that are more global in
(56:23):
scope, and a Canadian specificchannel as well. That's it for
this episode. Thanks forlistening.
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