What Software Experts think about Blood-letting

Software experts do NOT think about blood-letting. But ALL medical doctors thought about blood-letting and considered it a standard and necessary part of medical practice until well into the 1800's. They continued to weaken and kill patients with this destructive "therapy," even as the evidence against it piled high.

The vast majority of software experts strongly resemble medical doctors from those earlier times. The evidence is overwhelming that the "cures" they promote make things worse, but since all the software doctors give nearly the same horrible advice, things continue.

Blood-letting

Blood-letting is now a thoroughly discredited practice. But it was standard, universally-accepted practice for thousands of years. Here is blood-letting on a Grecian urn:

Consider, for example, the death of George Washington, a healthy man of 68 when he died.

Washington rode his horse around his estate in freezing rain for 5 hours. He got a sore throat. The next day he rode again through snow to mark trees he wanted cut down. He woke early in the morning the next day, having trouble breathing and a sore throat. Leaving out the details, by the time of his death, after treatment by multiple doctors, about half the blood in his body had been purposely bled in attempt to "cure" him of his sickness!!! If he hadn't been sick before, losing half the blood in his body would have killed him.

If you are at an accident and you or someone else is bleeding badly, what do you do? You stop the bleeding, because if you don't, the person will bleed to death. That's now. Then? You bleed the sick person because it's the universally accepted CURE for a wide variety of sicknesses.

Bloodletting was first disproved by William Harvey in 1628. It had no effect. It remained the primary treatment for over 100 diseases. Leaches were a good way to keep the blood flowing. France imported over 40 million leaches a year for medicinal purposes in the 1830's, and England imported over 6 million leaches from France in the next decade.

While blood-letting faded in the rest of the 1800's, it was still practiced widely, and recommended in some medical textbooks in the early 1900's. We are reminded of it today by the poles on barber shops -- the red was for blood and the white for bandages; barbers were the surgeons who did the cutting prescribed by doctors.

Blood-letting in software

By any reasonable criteria, software is at the state medicine was in 1799, when everyone, all the experts, agreed that removing half the blood from George Washington's body was the best way to cure him.

If you think this is an extreme statement, you either don't have broad exposure to the facts on the ground or you haven't thought about what is taken to be "knowledge" in software compared to other fields.

I hope we all know and accept that the vast majority of what we learn and come to believe is based on authority and general acceptance. This is true in all walks of life. Of course not everyone believes the same thing -- there are different groups to which you may belong that have widely varying belief systems. But if you're somehow a member of a group, chances are very high that you accept most things that most members of that group believes.

This is no less true in science-based fields than others. The difficulty of changing widely-held beliefs in science has been deeply studied, and the resistance to change is strong. See for a start The Structure of Scientific Revolutions. I have described this resistance in medical-related subjects, and in particular showed how the history of scurvy parallels software development methods all too well.

But at least, to its great credit, medicine has gone through the painful transition to demanding facts, trials and real evidence to show that a method does what it's supposed to do, without awful side-effects. That's why we hear about evidence-based medicine, for example, while there is no such thing in software!

I hear from highly-qualified and experienced software CTO's that they are going to lead a transition of their code base so it conforms to some modern cool fashion. One of the strong trends this year has been the drive to convert a "monolithic code base" (presumed to be a bad thing) to a "micro-service-based architecture." When I ask "why" the initial response ranges from surprise to a blank stare -- they never get such a question! It's always smiling and nodding -- my, that CTO is with-it, no question about it.

Eventually I get the typical list of virtues, including things like "we've got a monolithic code base and have to do something about it" and "we've got to be more scalable," none of which solves problems for the company. When I press further, it becomes obvious that the CTO has ZERO evidence in favor of what will be a huge and consequential investment, and has never seriously considered the alternatives.

As is typical in cases like this, when you scan the web, you see all sorts of laudatory paeans to the micro-service thing, very little against it. Most important, you find not a shred of evidence! No double-blind experiments! No evidence of any kind! No science of any kind! What you also don't find is stories of places that have embarked on the micro-service journey and discovered by experience all the problems no one talks about, all the problems it's supposed to solve but doesn't, and the all-too-frequent declarations of success accompanied by a quiet wind-down of the effort and moving on to happier subjects. Because of my position working with many innovative companies, this is exactly the kind of thing I do hear about -- quietly.

Conclusion

We've got a long way to go in software. While software experts don't wear white coats, the way they dress, act and talk exudes the authority of 19th century doctors, dishing out impressive-sounding advice that is meekly accepted by the recipients as best practice. No one dares question the advice, and the few who demand explanations generally just accept the meaningless string of words that usually result -- empty of evidence of any kind. It's just as well; the evidence largely consists of "everyone does it, it's standard practice." And that's true!

Software experts don't think about blood-letting. But they regularly practice the modern equivalent of it in software, and have yet to make the painful but necessary transition to scientific, evidence-based practice.

 

Comments

[Philip J. Philliou]

Good points. Very clever - "the history of scurvy parallels software development methods."

[Arthur Petrou]

Very insightful and the historical truth is unbelieveable. Former US Army Vice Chief of Staff Peter Chiarelli led the efforts of the Army--ignoring whatever the medical service corps wanted--and forced through changes for traumatic brain injury. When he was asked at the Harvard Club, how could he ignore the combined and overwhelming viewpoints of the medical service branch about TBI, particularly as he--Chiarelli--had no direct medical experience, Chiarelli responded: "General officers command specialists who have spent as many years analyzing their specialities as any medical specialist. The difference is, of course, that the logistics principles of Wallenstein and the arithmetic calculations of the drop of a fired artillery shell by Capt. Bonaparte were true when originically developed and are true to this day. More data has been generated but what Wallenstein and Capt. Bonaparte calculated were true then, at a time when medical science dictated that leeches be applied to drain "bad blood."" The General made it clear what he thought of combined medical thought.

[David B. Black]

The story about TBI is priceless, thanks for sharing...