This analogy is fundamentally flawed, both literally and metaphorically:
A surgeon isn’t a manager, they do the actual work! But
their skills and time are highly leveraged with a support
team that handles prep, secondary tasks, admin. The surgeon
focuses on the important stuff they are uniquely good at.
First, the literal.
Surgeons are managers of the operations they perform and heavily rely on the surgical team with which they work. If the author had any clue about surgeries, they would understand that the most important person in a major surgery is the anaesthesiologist, not the surgeon(s).
Second, the metaphorical.
The author goes to great lengths to identify "grunt work" as being "not the most intellectually fulfilling or creative part of the work." What they do not do is understand that there is no such thing as "grunt work" if, for any definition of work, it is valued without judgement.
But if a person identifies with being "the surgeon", with everyone else being "a support team that handles prep, secondary tasks, admin", then the post makes sense from an egocentric perspective.
I assume you haven't read The Mythical Man-Month[0]?
The author is referencing an existing analogy from Fred Brooks, and building upon it.
Sure, today the anesthesiologist might be the most "important" person in the room, but that's not the idea behind the analogy.
Your emphasis that surgeons "heavily rely on the surgical team" is just as important to Brooks' beliefs, in that the "Chief Programmer" is only able to do what they do via the support of the team.
The "grunt work" (noted by the author) seems solely focused on tasks given to the "Co-pilots" (or assistant programmers), notably with no specific mention to the other supporting roles (admin, editor, secretaries, clerk, toolsmith, tester, and "language lawyer"), many of which have been replaced by SaaS tooling (Github, Jira, Notion, Docusaurus, etc.) or filled by other roles (PMs, SDET, etc.).
Furthermore, the author even states:
> I hate the idea of giving all the grunt work to some lower-status members of the team. Yes, junior members will often have more grunt work, but they should also be given many interesting tasks to help them grow.
The author clearly sees less experienced programmers as mentees, rather than just some grunts whose work is beneath them.
The analogy may not be perfect, but their message about "AI coding tools" should be valued without judgement (and without accusations of egocentric thinking).
> I assume you haven't read The Mythical Man-Month[0]?
Actually, I have read Brooks' seminal work.
> Your emphasis that surgeons "heavily rely on the surgical team" is just as important to Brooks' beliefs, in that the "Chief Programmer" is only able to do what they do via the support of the team.
What Brooks described as "Chief Programmer" would now be called an "Architect" or "Principal Engineer", amongst other similar titles. Programmers at that time defined and verified their solutions before submitting them to be "encoded." This task was typically performed by "coders," being the people who transcribed programs into punch cards (or equivalent) for execution. The role of "coder" has long since been eliminated by the ability of programmers to encode their solutions themselves.
>> I hate the idea of giving all the grunt work to some lower-status members of the team. Yes, junior members will often have more grunt work, but they should also be given many interesting tasks to help them grow.
> The author clearly sees less experienced programmers as mentees, rather than just some grunts whose work is beneath them.
This is not clear to me at all. How does "giving all the grunt work to some lower-status members of the team" convey a mentor/mentee relationship and not exactly what the author states? To be exact, the author explicitly identifies a class of team members as being "lower-status."
> The analogy may not be perfect, but their message about "AI coding tools" should be valued without judgement (and without accusations of egocentric thinking).
Anytime someone equates "junior members" to "lower-status members" and uses self-aggrandizement to describe their role in an effort, I am going to call that out using the most charitable description I can - a purely egocentric perspective.
> the most important person in a major surgery is the anaesthesiologist, not the surgeon(s)
Could you explain more? It seems to me that, as sans surgeon there is no surgery, the surgeon is inevitably the most important person. Anæsthetic in its current form is a comparatively recent invention; historically major surgery was done without it, and in emergencies can still be done without it (at the cost of excruciating pain and far higher risk of negative outcomes, of course).
I learned about this recently, myself, and was surprised and ended up looking into it.
I read that the anesthesiologist is the person responsible for the patient during the surgery.
Apparently their role is:
- Provide continual medical assessment of the patient
- Monitor and control the patient’s vital life functions, including heart rate and rhythm, breathing, blood pressure, body temperature and body fluid balance
- Control the patient’s pain and level of consciousness to make conditions ideal for a safe and successful surgery
The gist I got from the other things I've read is that the anesthesiologist also has the most go/no-go responsibility before and during surgery.
Long ago I learned that anesthesiologists make more money than devs when starting out. Not a lot more, but most medical professionals do not.
When I asked why the answer was because it's the most dangerous job there. There's more opportunity to kill a patient with the anesthesia than any other means.
The main reason they don't want you to eat before surgery is that you can regurgitate and damage your lungs. But even if they solved that, the anesthesiologist's job is easier if you're in a fasting state both before and at the end of a surgery.
A quadruple bypass is not dangerous because you're stitching 4 new arteries onto a heart. It's dangerous because it takes so long to stitch 4 new arteries onto the heart that you're running up against the limits of how long you can safely keep someone sedated without causing life threatening complications.
I'm having trouble finding current statistics but at the time I was learning this, a double bypass was many times safer than a quadruple. Articles on bypass surgery understandably focus on the aspects that are within the patient's control.
> Experienced doctors, yes. Though I’m hearing some ridiculous salaries in SF.
There is no medical specialty except perhaps pediatrics/geriatrics where the pay will start below $200,000. There is a relatively modest effect of seniority on physician salaries (there is a huge amount of quality control/gatekeeping before one becomes an attending). This is nationwide, not in SF.
I'm not a developer but I don't think $300-400,000, normal salaries for fields like inpatient psychiatry or subspecialty medicine, are common for new developers, or even for any developer (vs a manager).
I thought the duration-related risk for that kind of surgery was based on how long the patient is put on a heart and lung machine? Naively I'd expect that to be riskier than the anesthesia.
That's a different specialty - perfusionist. Most surgeries with general anesthesia don't require a heart and lung machine and anesthesiologists aren't trained to operate one.
I do know all that, but it still doesn’t really seem enough to qualify them as the most important person. Sure, they have the biggest power of veto, but without the surgeon, there is no surgery at all.
Remove the anæsthetist, and procedure forbids you from continuing. Remove the surgeon, and it’s impossible to continue. … Or remove the patient. I guess the patient is the most important person there after all! (Actually, that does a pretty good job of showing how the entire notion of “most important” may not make sense.)
this line of thinking is flawed - remove this tiny resistor from the motherboard and the computer will not boot -> this proves this tiny resistor is as important as the CPU.
> I do know all that, but it still doesn’t really seem enough to qualify them as the most important person.
A surgeon can perform a procedure on a living patient or a cadaver and whichever is the case, it does not affect their work. An anaesthesiologist is responsible for ensuring the former does not become the latter, excluding catastrophic surgical procedure failure.
> Remove the anæsthetist, and procedure forbids you from continuing. Remove the surgeon, and it’s impossible to continue.
> But if a person identifies with being "the surgeon", with everyone else being "a support team that handles prep, secondary tasks, admin", then the post makes sense from an egocentric perspective.
They're not talking about other people being the support team. They're calling the AI tooling the support team.
The anesthetist is the person who is primarily responsible for the patient remaining alive. You can decide for yourself whether that's more or less important than what the surgeon's doing.
As someone who has had to have 3 surgeries in the last few years I'm very grateful that both the surgeon and anesthetist in each case did a fantastic job and didn't do anything like the author of TFA is suggesting. FWIW I don't think the analogy in the article survives knowledge of what surgeons actually do.
The analogy should give you a hint of your kind of responsibility and work.
It may be flawed but most people get the point especially compared to vibe coders who just wait outside the operating room
I find that a lot of similar analogies are flawed.
On the landing page of one of the frameworks (I don't remember which one, unfortunately) there was a description comparing a programmer to a woodworker.
It was written that this woodworker, as a reliable and skilled craftsman, makes meticulously each piece of furniture with the same care, which isn't really true. For example, quite often the back panels remained unfinished, with traces of aggressive planing.
So the whole premise that "this framework will help you craft software as meticolously as woodworker crafts furniture" doesn't check out.
Surgeons are managers of the operations they perform and heavily rely on the surgical team with which they work. If the author had any clue about surgeries, they would understand that the most important person in a major surgery is the anaesthesiologist, not the surgeon(s).
Second, the metaphorical.
The author goes to great lengths to identify "grunt work" as being "not the most intellectually fulfilling or creative part of the work." What they do not do is understand that there is no such thing as "grunt work" if, for any definition of work, it is valued without judgement.
But if a person identifies with being "the surgeon", with everyone else being "a support team that handles prep, secondary tasks, admin", then the post makes sense from an egocentric perspective.