The names “Virginia Tech” and “Cho” will be associated forever with the tragic mass homicide of 32 persons cum suicide by Seung-Hui Cho on 16 April 2007. In the aftermath, many questions have been posed: “What happened and why?”, “Was he crazy?”, “Could it have been prevented?”, “Could it happen here?” This was the third mass killing in a US campus, with the largest number of fatalities. The first was in 1966 in the University of Texas with 16 dead and 31 wounded, then the Columbine High School shooting in 1999, in which 13 students were killed. We do not profess to know more about what happened in Blacksburg, Virginia, or Cho’s neuropsychiatric condition than whatever is published in the popular press.1 But through a series of questions, we reflect on this tragedy, attempt to place it into a human and psychiatric perspective, and offer insights into if, and how, it can be averted in the future.
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