Maybe growing numbers of "damned if you do, damned if you don't" situations are the natural result our current 'late stage' medicine.
An analogy that came to mind: an enormous, largely opaque codebase that works very well. Most of its behaviours given most inputs are well understood, most of the time, and endless optimizations have caused it to reach a pretty good level of stability.
But maybe, going forward, more and more small optimizations and bug fixes cause as many problems as they fix.
