To me, it isn't about the knife blade being sharp or dull, but rather how slippery of a handle you have attached to the knife. Monkey patching is a sharp blade,

To me, it isn't about the knife blade being sharp or dull, but rather how slippery of a handle you have attached to the knife. Monkey patching is a sharp blade, but concerns are a slippery handle. Concerns make reasoning about code more difficult once large enough. Further, the difference between a "just-right" sized code base and a confusing bloated one is often time and consistency. When nobody has the time to do the necessary refactor, the concerns start interacting. This is the aforementioned slippery handle.