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Dr. Liz’s Blog

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Fragility of Life & Sukkot

18/   October, 2019

My marriage survived putting up our sukkah … 🙂
Happy World Menopause Day! Happy Sukkot!

We are now in the time of year of a lot of Jewish holidays.

The Jewish holidays go in cycles and right now we’re in the beginning of the yearly cycle. So first there’s the Jewish New Year, which is a very happy time and there’s apples and honey and while everyone is trying to keep the start of the school year going, we say, “Happy New Year!”

Then there are ten days that people often refer to as the Days of Awe. It’s a time of introspection and you’re supposed to take an accounting of yourself. A reckoning of your life and who you are as a person. You’re supposed to look inwards very deeply.

Have you heard of Napoleon Hill’s book, Think And Grow Rich? I often start books at the end. At the end of that book is a questionnaire with about, I don’t know, over 100 questions and it’s all about taking an inventory of yourself.

The ten days of introspection culminate on the 10th day, which was last Wednesday. That was Yom Kippur, a day of fasting. Luckily, the power wasn’t cut out. I was thinking of 700 people in our synagogue with no air conditioning to keep us awake. That would not have been good, but that worked out.

Then it keeps going with lesser known holidays! We are in one of those right now. The holiday that we’re in, I know there are some of you that know it is called …


Sukkot, which is plural in Hebrew for sukkah. And sukkah means booth. We actually build a sukkah every year and then take it down. It’s meant to be a temporary shelter. It’s meant to remind us of our connection to nature, and of the fragility of life, since it is not supposed to be able to withstand strong weather.

A sukkah has a few requirements. It has to have a good clear opening. It can’t be a solid structure with a door. It has to have an opening.

It also has to have a roof that is not complete, a roof through which you can see the stars. Depending on who you ask, you can see God, nature, etc, depending on your beliefs. And the roof has to be made of some organic material.

Every year I learn a little something new, and this year I learned that the roof has to be made from some type of material that used to grow in the ground and has now been somewhat freshly, recently removed from the ground or from a tree.  It also can’t have been made into another useful purpose. For example, it can’t be a mat woven from other natural material.

So it’s really not something you can keep from year to year. Most typically people put palm fronds. We have a friend at our synagogue who’s super organized and remembers ahead of this holiday every year to ask her gardener to gather palm fronds. She had so many palm fronds that she allowed us to go over and take all the ones that we needed for ours after they’d already done their huge sukkah.

We have a kit to build our sukkah. I’m happy to report that my husband and I stayed married on Sunday while he managed to build this. Together, we put the palm fronds on top.

The point is to be able to see and feel our fragility, our vulnerability. That is the point of dwelling in a temporary structure. Some people take it really seriously. They will spend nights in there like overnights with the kids. So far in my life, I have not done that.

Even though our recent heat wave picked an inconvenient time to go away, we’ve had a wonderful time eating meals in our sukkah as often as possible. Our little almost three year old granddaughter the other night came over and we made some little paper decorations and put them up in our sukkah and said the blessing over the lulav and the etrog with her. The picture above shows the cool rope-lighting we put up this year.

What’s a lulav and etrog?

There are four plant species that we use for blessings for this holiday. The lulav is a gathered set of small branches of palm frond, myrtle and willow. These have to be fresh every year. We shake the lulav and we say prayers. (This is partly, in my mind, why some people think Jewish people are so bizarre because we do things that if you look at it from the outside, it’s looks really weird and different!)

And the fourth is these plant items called an etrog. It is very special and comes all the way from Israel, unfortunately in a lot of packing materials which are there to protect the little stem on one end. If that little stem is not there, it’s not valid for the blessing ritual. When you lightly scratch the surface of this special type of lemon, it smells beautiful, so fragrant.

A Jewish lemon all the way from Israel!

During Sukkot, we are also supposed to have guests in our sukkah as often as possible. While dwelling in the fragile structure, we find strength and support with family and friends.

Every year we go through the cycle again. We have the opportunity to ask the same questions again, to discover new meanings and new ways of experiencing our own faith and also to dwell in the sukkah, look up at the stars and the sky, and remember the fragility of life.

True Risk of Breast Cancer

03/   October, 2019


Have you heard that the average woman’s risk of breast cancer is 1 in 8? This is the risk as understood by most doctors and that I have often quoted to others.

One in eight sounds pretty scary, and I am passionate about dispelling unnecessary fear.

My mind was recently blown when I learned that this risk of 1 in 8, or about 12%, is NOT your risk right now. 

It is actually your total risk over your entire lifetime if you live to be 85 years old.

Your Actual Risk

Broken down by decade, your actual risk looks like this:

Age Decade Absolute Risk of Breast Cancer Percentage
30’s 1 in 227 0.4%
40’s 1 in 68 1.5%
50’s 1 in 42 2.4%
60’s 1 in 28 3.6%
Over 70 1 in 26 4%

Source: Patricia R. Kelly, PhD, Assess Your True Risk of Breast Cancer

Add up the percentages to get 11.9, or about 12% total lifetime risk.

Even if no one in your family has had breast cancer, now with social media, everyone knows or has heard of someone who has had breast cancer. The stories range from scary to inspirational.

My Mom’s Story

My mom had early-stage breast cancer when she was 68 years young. It was found on a mammogram (it’s a good story – watch the video at the top☺), treated and cured. I know the word “cure” is tricky to use, but another fact is that more than 90% of women diagnosed with early breast cancer are cured and need no further treatment. 

Even so, with my family history, I wait in suspense every year between my mammogram and the letter saying the results are normal (the letter I have gotten every year so far, thank goodness).

This October, in honor of Breast Cancer Awareness Month, I’m going to spend the month sharing information with you about the benefits of (the right kind of) hormone replenishment to lower your risk of breast cancer (both initial and recurrent breast cancer).

Make sure your friends are on this e-newsletter list or connected with me on social media for all the pearls I want to share with you, this month and in the future.

Estrogen prevents Breast Cancer?

I’ll leave you for now with one more shocker: the scientific data shows less breast cancer in women who use estrogen.

Stay tuned for more!

Please leave your comments and questions below.

The Village Clinic – Safari Doctors

06/   August, 2019

It was a blessing and privilege for me to help Safari Doctors on Pate Island, Lamu archipelago, Kenya in July 2019

I wish you could have been there.

The clinic looked more like an abandoned house. Cement floors, no electricity, no running water. Nothing in the windows. The waiting area had a bench on one end where few people could sit down, and at the other end was the pharmacy which was basically a table with a scattered array of boxes, and tubes, and jugs of all kinds of different medicines.

5 Tips to Stay Healthy During Summer

02/   July, 2019

Summer can either be a time to work on your health or to let it go completely. Because I like happy mediums, here are my thoughts on how to strike a balance.

Sleep helps lose weightTip #1 – Get some extra sleep.

Many of us will take some time off during the summer, and either travel or just do a fun “staycation”. Also, many parents I know have a more relaxed schedule during the summer simply because the kids don’t have to be up and out early in the morning. Even an extra thirty or sixty minutes of sleep in the morning can make a big difference in your health, especially if you’re working on losing weight.

Why I Ignored My Mother’s Advice and Did It Anyway

04/   June, 2019

Dr. Liz and Dr.Norah Gutrecht

With my mom at my medical school graduation, 1990

It’s true. My mother was terrified when I told her I was going to climb Mt. Kilimanjaro.

She pictured ice picks, ropes, oxygen masks, and dangerous ravines. I calmed her fears by sending her a picture from my Kili guide book showing (the truth) that most of it consists of beautiful hikes.  All I needed were good hiking boots, warm clothes, and sturdy poles.

My mom has always thought I was a little crazy. I often gave her good reason to think so.

Who celebrates turning 50 by climbing up a mountain?

It made perfect sense to me. I thought it was the perfect way to demonstrate (mostly to myself) that getting older does NOT mean declining or shrinking away from living life out loud.

Help me name the baby

06/   May, 2019

Don’t worry, I’m not having a real baby! That factory closed a while ago ☺

[Click here if you want to skip to the 2-question survey on which book title is better!]

My first “baby”

My first “baby” was born in 2009 when Dr. Liz’ Easy Guide to Menopause was published. It was a relatively easy birthing process. I was in a book-writing boot camp, which set me up well to write a strong outline that represented the “5 Steps” that I still do to this day with every patient I work with in my practice.

A Tribute to Geraldine Ferraro for Women’s History Month

26/   February, 2019

The year was 1984. The place was San Francisco at the Moscone Convention Center for the Democratic National Convention. The excitement was palpable. History was about to be made. Walter Mondale, after interviewing several possible candidates, chose Geraldine Ferraro as his running mate in the 1984 presidential campaign.

Gerry, as she was known, made history by becoming the first woman on a major party ticket in a presidential election.

And I got to meet her!

Gerry did not have it easy as the child of Italian immigrants growing up in New York City. When she was only eight years old her father died, leaving her mom to raise her and her brother. In high school, not surprisingly, she was voted “most likely to succeed.” When she finished high school, her uncle said, “Why send her to college? She’s pretty. She’ll get married.” Her mother said, “No way. She’s getting a full education.”

Balance Your Hormones to Improve Your Sex Drive

11/   February, 2019

Lack of sex drive is a common reason women come into my office.

I appreciate this because sex drive – a.k.a. libido – is not only about sex. Libido reflects motivation, drive, passion in life.

Libido reflects life energy.

I also appreciate when women acknowledge the importance of sexual health and intimacy for the health for their relationships.

[I think most men are much quicker than most women to admit the importance of sex in their lives. What do you think? Comment at the end of this blog.]

Evaluating a woman with a low sex drive starts with questions about her physical health.

  • Is she perimenopausal or menopausal?
  • Does she have vaginal dryness?
  • Does she have pain or discomfort with sex?

If a woman is in menopause or perimenopause (the 10 or more years leading up to menopause), her hormone levels might be rising and falling, affecting her sleep, mood, sex drive, and more.