Here is a searing account--probably the best yet published--of life in the underclass and why it persists as it does. Theodore Dalrymple, a British psychiatrist who treats the poor in a slum hospital and a prison in England, has seemingly seen it all. Yet in listening to and observing his patients, he is continually astonished by the latest twist of depravity that exceeds even his own considerable experience. Dalrymple's key insight in Life at the Bottom is that long-term poverty is caused not by economics but by a dysfunctional set of values, one that is continually reinforced by an elite culture searching for victims. This culture persuades those at the bottom that they have no responsibility for their actions and are not the molders of their own lives. Drawn from the pages of the cutting-edge political and cultural quarterly City Journal , Dalrymple's book draws upon scores of eye-opening, true-life vignettes that are by turns hilariously funny, chillingly horrifying, and all too revealing-sometimes all at once. And Dalrymple writes in prose that transcends journalism and achieves the quality of literature.