[HN Gopher] Code Like a Surgeon
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Code Like a Surgeon
Author : simonw
Score : 60 points
Date : 2025-10-24 15:25 UTC (7 hours ago)
(HTM) web link (www.geoffreylitt.com)
(TXT) w3m dump (www.geoffreylitt.com)
| _wire_ wrote:
| My god, don't code like a surgeon!
|
| Code like a programmer.
|
| This article further emphasizes the obvious point that as
| programmers are well on the way to destroying their own
| profession and their work is poised to wreck the entire world,
| that it's time raise awareness that programmers work with much
| less discipline and responsibility than other professional,
| accredited, licensed trades, like say... doctors.
|
| But for now, sure, why not just compare yourself to surgeons, as
| you already anoint yourselves as "engineers".
| GMoromisato wrote:
| If we're going down this road, then I claim programmers are
| more skilled than engineers or doctors.
|
| 90% of engineers are not inventing new things--they are merely
| applying codified knowledge (which they didn't create) to a new
| location or instantiation. In contrast, every new program is
| unique in the world (if it were not then it wouldn't need to be
| written--you'd just copy/fork/download the program).
|
| And don't get me started on doctors. More than 40,000 Americans
| die _each year_ from medical errors[1]. You really think the
| casualty rate from programmers--with all our mistakes--can beat
| that? I don 't think so.
|
| So, yeah, maybe surgeons are not the right model. Maybe
| surgeons could learn a thing or two from programmers.
|
| -------------
|
| [1] https://journalofethics.ama-assn.org/article/medical-
| errors/...
| macintux wrote:
| > You really think the casualty rate from programmers--with
| all our mistakes--can beat that?
|
| I think that if my infrastructure + code had any direct
| connection to patient outcome, there would be a lot of harm
| done. Not that I'm particular bad at either, but I know the
| effective cost of errors is minimal, and certainly does not
| have a direct impact on people's health. If I had the same
| responsibilities as a surgeon, I'd have a much slower rate of
| change in my systems.
|
| I do not in any way believe that the fact that we in IT kill
| fewer people than surgeons has any meaning for whether we're
| more skilled than doctors.
| jibal wrote:
| Analogies aren't comparisons.
| simonw wrote:
| I really like Geoffrey Litt's new analogy for working with AI
| coding tools:
|
| > Personally, I'm trying to code like a surgeon.
|
| > 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.
|
| It's also a neat callback to the Mythical Man Month, the most
| influential early textbook on large scale software engineering.
| sublinear wrote:
| I sometimes use AI summaries to get the answers I need out of
| badly written documentation. That's about as far as I find any
| value or productivity boost.
|
| Consider that this "surgeon" analogy has always been applicable
| when docs or books are better written and full of useful
| examples. Also consider that a lot of the annoying "plumbing
| code" you probably want AI for is fairly closed-ended as there
| are only so many combinations of API use possible.
|
| I'm really not understanding the continued hype in 2025.
| simonw wrote:
| How much time have you spent running a coding agent like Claude
| Code, and have you tried running one in auto-approve (aka YOLO)
| mode yet?
|
| I've written a bunch about those recently:
| https://simonwillison.net/tags/coding-agents/ - including a
| couple of video demos
| https://www.youtube.com/watch?v=VC6dmPcin2E and
| https://www.youtube.com/watch?v=GQvMLLrFPVI
| meindnoch wrote:
| Simon, we don't care.
| simonw wrote:
| _You_ don 't care.
|
| And OK, I get that my persistence in trying to help people
| understand this stuff can be annoying to people who have
| already decided that there's nothing here.
|
| But in this case we have someone who looks like they are
| still operating on a 2024 model of how this stuff can be
| useful.
|
| The "coding agents" category really does change things in
| very material ways. It only kicked off in February this
| year (when Claude Code released) and if you haven't yet had
| the "aha" moment it's easy to miss why it makes such a
| difference.
|
| I'm not going to apologize for trying to help people
| understand why this matters. Give how much of a boost I'm
| getting from this stuff in my own work I honestly think it
| would be unethical for me _not_ to share what I 'm
| learning.
| saulpw wrote:
| Yes, code like someone might die if you make a mistake!
|
| Can you imagine a surgeon using Claude Scalpel as an agent to
| just go ahead and fix that one artery?
| BrokenCogs wrote:
| Yes, I know several careless surgeons who don't check their own
| work
| ThrowawayR2 wrote:
| A surgeon has 4 years of undergraduate education, 4 years of
| medical school, and a 5 year residency, learning to operate (pun
| intended) with other equally highly trained specialists, many of
| whom are peers, like anesthesiologists, not merely support. The
| comparison was already dubious when Brooks made it for operating
| systems programming. Setting up a comparison with the average "I
| don't use anything I learned in my CS degree, lol" coder
| wrangling a chorus of hallucinating stochastic parrots is a
| bonkers level of hubris from techbros.
| BrokenCogs wrote:
| Most surgeons don't use anything they learn in medical school
| or residency either. It's usually their last 2 - 4 years
| (depending on whether they did a fellowship) that is useful in
| their day to day job. E.g. an eye surgeon doesn't need to know
| how to read an ECG
| jibal wrote:
| Analogies aren't comparisons.
| asimovDev wrote:
| it's the second time this week I see this link being posted and
| it's the second time this week I read it as a 'sturgeon'
| jibal wrote:
| Theodore?
| BrokenCogs wrote:
| I'm somewhat of a prompt surgeon myself. I find prompts online
| and then hash them together to fit my needs.
| handfuloflight wrote:
| frankensteinian
| neilwilson wrote:
| So the Chief Programmer Team structure [0] is back in fashion is
| it.
|
| But this time with agents.
|
| Fred Brooks has never been more relevant.
|
| [0]: https://en.wikipedia.org/wiki/Chief_programmer_team
| gklitt wrote:
| Yes, I cite Brooks (and Harlan Mills, seemingly the original
| source of the idea) in the post!
| neilwilson wrote:
| I'm just glad I'm not the only one revisiting past structures
| that fell apart at the time because they involved humans.
|
| Now we have human like automation, everything needs
| revisiting.
| kulahan wrote:
| I'm kinda surprised this isn't more popular. I figured we'd go
| this way eventually as we single out 10x-ers, give them a
| highly competent crew, and save a lot of money over your most
| expensive code monkey wasting time attending meetings, filling
| out Jira tickets, and giving presentations to the customer. You
| pay them a shitload of money - shouldn't you get every dollar's
| worth?
|
| Honestly, at every job I spend an unreasonable amount of time
| getting up to speed on things that are only tangentially
| related to my job (No, here we need you to check all the boxes
| in the Jira ticket, ensure it's linked to a zephyr ticket, and
| ensure it's linked to a git PR - we don't care about you adding
| attachments or comments!)
| glenjamin wrote:
| This reminded me of a slide from a Dan North talk - perhaps this
| one https://dannorth.net/talks/#software-faster? One of those
| anyway.
|
| The key quote was something like "You want your software to be
| like surgery - as little of it as possible to fix your problem".
|
| Anyway, it doesn't seem like this blog post is following that
| vibe.
| martin-t wrote:
| I like this quote.
|
| Unfortunately, my predecessor at work followed a different
| principle - "copy paste a whole file if it saves you 5 minutes
| today".
|
| Well, I am still a surgeon, I just do a lot of amputations.
| Blackarea wrote:
| > Code like a surgeon ... As a UI prototyper
|
| XD yes sure. I'd most definitely put those on the same level.
| Maybe even favor an UI prototyper if it comes down to the real
| deal. Who needs an open heart surgery when you can have a
| magnificent css-hover animation that really seals the deal on
| some 90%-AI-generated slob that only caters to delusional top-
| management completely out-of-touch with reality.
|
| Irony off: Let's try it with a bit of humbleness next time, ey?
| jumploops wrote:
| I've long advocated that software engineers should read The
| Mythical Man-Month[0], but I believe it's more important now than
| ever.
|
| The last ~25 years or so have seen a drastic shift in how we
| build software, best trivialized by the shift from waterfall to
| agile.
|
| With LLM-aided dev (Codex and Claude Code), I find myself going
| back to patterns that are closer to how we built software in the
| 70s/80s, than anything in my professional career (last ~15
| years).
|
| Some people are calling it "spec-driven development" but I find
| that title misleading.
|
| Thinking about it as surgery is also misleading, though Fred
| Brooks' analogy is still good.
|
| For me, it feels like I'm finally able to spend time architecting
| the bridge/skyscraper/cathedral, without getting bogged down in
| terms of what bolts we're using, where the steel come from, or
| which door hinges to use.
|
| Those details matter, yes, but they're the type of detail that I
| can delegate now; something that was far too expensive (and/or
| brittle) before.
|
| [0]https://en.wikipedia.org/wiki/The_Mythical_Man-Month
| makeitdouble wrote:
| > bridge/skyscraper/cathedral
|
| > Those details matter, yes, but they're the type of detail
| that I can delegate now
|
| No...
|
| If you're building a skyscraper, there's no world where you can
| delegate where the steel or bolts come from. Or you'll at least
| need to care about what properties that exact steel has and
| guarantee every bit used on your project matches these
| constraints.
|
| If you don't want to care about those, build residential houses
| with 1000x less constraints and can be rebuilt on a dime
| comparatively.
|
| You might be thinking about interior decoration or floor
| arrangement ? Those were always a different matter left to the
| building owner to deal with.
| notnmeyer wrote:
| > My current goal with AI coding tools is to spend 100% of my
| time doing stuff that matters. (As a UI prototyper, that mostly
| means tinkering with design concepts.)
|
| this struck me as weird. both in terms of "tinkering" being the
| most important thing to be doing, and then also describing
| "working like a surgeon" to be tinkering.
| jibal wrote:
| That isn't how analogies work--they are about partial
| similarities, not equivalence. The OP never says or implies
| that working like a surgeon is tinkering--allowing focus on the
| most important thing to be doing doesn't mean that the most
| important thing is the same for everyone.
| simonw wrote:
| Yeah, if an analogy is an exact match it's not an analogy any
| more.
| alganet wrote:
| The Mythical Man-Month _focuses_ on a simple idea.
|
| It can be summarized as "adding more workers to a project does
| not speed things up, that's a myth".
|
| It's in the title of the book. It's a good book.
|
| The entire IT field is about to test that idea in a massive
| scale. Can lots of new automated workers speed things up? We'll
| see.
| adamzwasserman wrote:
| Another way of saying this is:
|
| If your development team consists of autistic junior programmers
| with eidetic memory, then you damn well better make sure that
| your documentation is exceedingly thorough, absolutely
| unambiguous, and as restrictive as you can make it.
| moffkalast wrote:
| Not to be confused with coding like a sturgeon which is blub blub
| blub blub
| libraryofbabel wrote:
| It's a nice analogy, and I think I'll use it in future.
|
| If you want another one, think of painting. An "Old Master"
| painter like Rembrandt or Rubens or Botticelli would have had a
| large workshops with a team of assistants, who would not only do
| a lot of the work like stretching canvases or mixing the paints,
| but would also - under the master's direction - _actually do a
| lot of the painting too_. You might have the master sketch out
| the composition, and then paint the key faces (and, most of all,
| the eyes) and then the assistants would fill in areas like
| drapery, landscape, etc.
|
| This changed in the Romantic period towards the end of the 1700s,
| with the idea of the individual artist, working alone in a moment
| of creative inspiration and producing a single work of genius
| from start to finish. Caspar David Friedrich or JMW Turner come
| to mind here.
|
| Some programmers want to be Turner and control the whole work and
| feel their creativity is threatened if a machine can now do parts
| of it as well as they could. I'd rather be Rembrandt and sketch
| out the outline, paint the eyes, and leave the rest to junior
| engineers... or an AI Agent. It's a matter of preference.
| kragen wrote:
| Like a surgeon Coding for the very first time Like
| a suuuuurgeon Let your script run Close to mine
| ivape wrote:
| "First, do no harm".
|
| "Surgically" is how one enters a foreign codebase, especially
| legacy ones.
| phren0logy wrote:
| The analogy I have used is "AI as sous chef."
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