Dear Dr. Hollmann,
I've worked in pediatrics for a year and a half and I'm sick all the time. I take vitamins and exercise when I can. I also take elderberry with zinc twice a day and wash my hands until they are as dry as the desert. I like what I do, but I'm not sure it's worth it when I'm sick all the time. Do you have any suggestions about what else I can do to prevent illness?

One of my favorite teachers was a pediatric infectious diseases specialist. While, sadly, I probably have forgotten a lot that he taught us, I do remember him talking about the effects of starting an internship in pediatrics. He explained how you'd be sick a lot until you built up immunity to the local viruses. Then, once you were doing well, your residency would be over and off you'd go to the next patient community, where it started all over again.

I don't think there are a lot of studies on all this, but the fact is that doctors, nurses, and healthcare professionals are not sick all the time. Even moms aren't. We are all frequently exposed to most of the common causes of infection, and sometimes we get sick, and sometimes we don't. This simple fact remains one of the largest mysteries in medicine.

One of the keys to staying healthy as a healthcare worker is following good infection-control practices. Most of the acute illnesses in a pediatrics office are viral. Good hand-washing can protect you against some (but not all) of those bugs. Taking precautions like handling diapers and blood with care, using gloves, etc., helps and, in some cases, is essential. Masks are sometimes worn by patients and healthcare workers as a safeguard, as they were during the recent flu epidemic. Unfortunately, the good old cold virus is tough to kill and, for some airborne viruses, there is not a lot known about how effective masks truly are.

Also important to maintaining good health (wherever you work) is taking proper care of yourself. People who are fit, well rested, do not smoke, and get plenty of good nutrition are less likely to get sick. When they do get sick, they do better. It's important to note that if you're eating a well-balanced diet, vitamins are not likely to help, and elderberry with zinc will probably not make a difference.

Now, if you dramatically reduce your exposure to the public by taking another job, you will probably reduce your risk of viral illness some. But I bet people who work in all kinds of settings can tell you about customers or coworkers who pass along bugs. My guess is that you will stop getting sick all the time. In the meantime, a moisturizer or hand cleaner with moisturizer may help reduce the dryness in your hands.