Yeah, every time I read something he's written, or written about him, it's a good read. I've always considered myself good at understanding how systems work together, mainly with web applications from front (html/css/js) to back (http/app/services/sql), but Carmack does that with very low level/detailed applications... It's hard for me to imagine.
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What really hurt us was the initial thought of putting a web interface on it. Some things surrounding the game were certainly overly trivialized by us. That's easy to do when you say, "Oh, we're hotshot game developers. This web stuff can't be too hard because so many people do it."
There's a little bit of a humbling lesson there in how much work we did have to do with all the things on browser compatibility and backend database integration and optimization.
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In absolute terms I think there are more people than ever programming this way today. Just doesn't feel that way because there are even more people doing stuff differently.
Low level and also advanced geometry. IIRC he was one of the first to ship real time dynamic shadow rendering. I can't judge the math behind it, but it wasn't trivial for sure.