HERE ARE some symptoms of scabies: night itching, rashes between the fingers, pencil-mark lines. Here is a diagnostic finding: trails under the skin where mites lay their eggs. These are called burrows, which sounds altogether too homey. Here is a treatment: permethrin 5 percent topical cream, after washing clothes and bedsheets in very hot water. Here is the problem: Most shelters have no public washing machine, and a load in the local laundromat runs $6 to $7.
We had seen him in the shelter for a few weeks. Before voices drove him into the clinic — their intrusiveness was almost an act of compassion — he lived and drank for years on the street. He was still drinking, but accepted antipsychotic medication, and a referral for primary care, since he hadn’t been to a doctor in decades. He didn’t mention the scabies.