The document discusses problems managing large Postgres installations containing terabytes of data. Key issues include: system resource exhaustion from running out of inodes or file descriptors; slow performance from huge catalogs, statistics collection, and backups that take many hours; and handling VACUUM problems like bloat and transaction wraparound. Solutions proposed include using connection poolers, moving statistics files to RAM, upgrading Postgres versions, and avoiding clusters with over 400,000 tables.