I could be wrong, but my understanding is that MUMPS/M seems more analogous to a Database with a built-in language than a language with a built-in database, although having said that, the distinction seems pretty fine to me. Is Company X SQL, which can have sprocs and such, also a language with a database baked in?

As an aside: Does anyone (other than Epic Health Systems or whoever) use Mumps/M at any kind of scale? I hear that the issues with global namespacing can become really burdensome above even small thresholds.

The Veterans Administration's health system - one of the largest in the world - runs on Mumps, as does Epic Systems which powers a large percentage of the medical practice/hospital systems in the U.S. TD/Ameritrade runs some systems on M as do many banks. I have heard that ATM systems have used it in the past, though not sure if they still do.

The system that gathers data for California birth certificates and related [pre]natal health stats reporting is written in MUMPS/M/Cache.

I’ve not worked with the code for that, though - we are in the process of replacing it. The fellow that originally created the system decades ago has been in “semi retirement” for quite a while, and it’s hard to find people that want to work on the platform. So, we are doing a replacement in (mostly) Java, of course. And I don’t even especially like Java, but it pays the bills in the Sacramento area.

I suspect the bigger scaling issues with the codebase are “people-ware”, and thus the push (in most shops and projects) to go least common denominator on programming platform choice, sadly.

Petroleum industry used to use Pick where I lived for some distribution software, but it seems it's main place is medical records software from what I've heard).

It is a fine distinction I suppose, although the Pick stuff I've looked at was more than just stored procedures - TUI/GUI support for apps (mostly dumb terminal based but Cache probably has some GUI stuff in there now), overnight batch scripts and report creation etc.

I haven't used MUMPS, but did a little bit of time with Pick and later on Cache. I believe Pick systems were often more than just the multi-valued database and absolutely horrendous language, in that they were often tightly integrated into the OS too - disk storage, terminal support etc.