Filled with poignant stories of women and men trapped in destructive behaviors and environments, this volume puts forth a vision of the modern world and of intellectualized modernism as hell but offers few concrete or theoretical solutions. Dalrymple, a noted conservative columnist in London's the Spectator, collects pieces he wrote for the conservative City Journal, using his own work as a physician in British slums and prisons as fodder for an analysis of the underclass: "not poor... by the standards of human history" but trapped in "a special wretchedness" from which it cannot emerge. Most of his patients put their violence in the passive: the murderer who says "the knife went in" as though he had no control; the man who beat his girlfriend and then exclaimed, " `I totally regret everything that happen' [sic] as if... [it] were a typhoon in the East Indies." The fault, Dalrymple asserts, is not bad environments, but a pervasive liberal view and agenda that creates "passive, helpless victims," encourages the idea that the acceptance of "unconscious motivations for one's acts" obviates personal responsibility, and the "widespread acceptance of social determinism." Dalrymple makes many astute observations on British social attitudes about wealth, the tattooing of white youths and urban redevelopment, and his writing is graceful and often witty. But his main points get hammered home too quickly and too often. His critique of liberalism and the welfare state, while sometimes provocative, is spelled out in the introduction and repeated again and again. While Dalrymple is preaching to the converted, his vivid writing and often heartbreaking stories rise above his deeply felt but repetitive social analysis.