"Out of the crooked timber of humanity," as Kant and Isaiah Berlin powerfully assert, "nothing entirely straight can be made."

Is it possible to understand, confront, and even prevent genocide? Has much been learned and done? Can we, as psychiatrists and citizens, do anything about it? David Hamburg—for many decades one of the world's most thoughtful and distinguished psychiatrists and a significant figure in international thinking about mass violence, war, and genocide—marshals a rather staggering array of evidence and ideas from many disciplines in his current book, which is an updated and revised version of a 2008 book with the same title.

Dr. Hamburg, for those unfamiliar with his life, is a psychiatrist with a public health background who has been a professor at Stanford and at Harvard and is now a Distinguished Scholar at Weill/Cornell. He has been President of the Institute of Medicine, the National Academy of Science, and the American Association for the Advancement of Science. His many awards include the U.S. Presidential Medal of Freedom. He was president of the Carnegie Corporation for 14 years and has served on and/or chaired countless major national and international advisory boards. His books include Learning To Live Together, No More Killing Fields, and Today's Children.

History, politics, economics, diplomacy, war, psychology and psychiatry, sociology, anthropology, and biology are all relevant to Dr. Hamburg's tasks in the current book, which stresses public policy and prevention. His sources, quotations, references, and interactions are heavy with names from academia but also names from differently powerful worlds, such as Annan, Carter, Gorbachev, Tutu, Solana, Vance, Mandela, Nunn, Sachs, Sen, and Urquhart as well as Armenia, Nazi Germany, the Soviet Union, Yugoslavia, Cambodia, Rwanda/Burundi, and Darfur.

Dr. Hamburg reminds us that genocide is old, not new, even if mankind's weapons have become on the whole more lethal, and that genocide usually follows years of clear warning signs. After a general overview, he devotes a full chapter to each of several notable and much-studied illustrative 19th and 20th century examples, including what led up to them and what was and was not done: Turkey/Armenia, Nazi Germany, and Burundi/Rwanda/Tutsi/Hutu. He then devotes a more hopeful full chapter to a place and recent time where genocide might well have happened but did not: South Africa at the end of Apartheid.

Dr. Hamburg has a patient, tenacious, and hopeful interest in prevention on a grand scale. That he is so widely informed and reasonable may make anyone, such as the current reviewer, who is a bit more pessimistic than Dr. Hamburg appears to be about these issues, feel a bit wrong or even churlish. I would like to be as optimistic as Dr. Hamburg is in this book, but my psychiatric views about individual biopsychosocial people and the primitive and destructive impulses of our species, including mankind's capacity for creating, ignoring, tolerating, and even enjoying savagery, violence, war, and genocide, may be darker than Dr. Hamburg's view of them. I also read some of the political evidence in a darker light than I think Dr. Hamburg does. That area includes perennial spoken and unspoken, hugely conflicting demands within the realms of politics and economics; the continuing usefulness, to far too many leaders, of war and of scapegoating; people's deep openness to propaganda and demagoguery; what governments did and did not do before, during, and after Turkey/Armenia, Nazi Germany, and Rwanda/Burundi; and the recent efforts and successes by governments in narrowing the definition of genocide for their perceived national convenience and in avoiding calling genocide genocide, lest they be pressed to act. That the book largely leaves out, as a likely potential agent for change, the United States, with its current reductionist business model as a substitute for government, seems to me to be notable and probably realistic.

In his introduction, Dr. Hamburg emphasizes proactive help to countries in trouble. He recommends the formulation and dissemination of specific response options to deal with early warning signs. He draws together tools and strategies to prevent mass violence. He clarifies what international organizations can do and emphasizes the roles of democracies. He looks at preventive uses of cooperation, conflict resolution, and democratic socioeconomic development. He suggests developing two large cooperating international centers for prevention of genocide, as well as many smaller contributory structures. He suggests tasks for the next decade (e.g., in expanding linkage). And he urges encouraging leaders by molding a constituency for prevention by public education. He is concerned with education, or training, for hatred as one reason to insist on education for social and civic strength. All these goals would seem to many of us reasonable and admirable.

He has a section called Pillars of Prevention, with chapters on preventive diplomacy, democracy and prevention of mass violence, equitable socioeconomic development, education for survival, human rights abuses and international justice, and restraints on weaponry. He supplements that with a list of what he considers a few recent advances in preventing mass violence, such as Kofi Annan's work in Kenya in 2008, and some restructuring of the United Nations.

He is an expert on relevant institutions and organizations, and this becomes the focus of the third major section of the book, which looks at the United Nations, the European Union, the Organization for Security and Cooperation in Europe, NATO, and many smaller potential contributors, several of which he has helped to build and/or strengthen. He does several times note—without, in my judgment, fully acknowledging the power of—obstacles and limitations and conflicting aims in those organizations.

It is an impressive book, painted on a large canvas. One might wish that the next edition be a bit more tightly edited to reduce repetitiveness and perhaps to leave room for further development of thought, or books, on some unwieldy areas only briefly touched on, such as religion, the psychology of ideologies, nationalism and tribalism, the sociobiology of aggression, and perhaps even the implications of climate change. Overall, however, this book will usefully challenge some of any reader's basic values and assumptions. It is a hopeful, widely informed, widely thoughtful, and quite readable one-man multidisciplinary survey of an unpleasant and important topic that makes many of us angry and most of us sad and uncomfortable.