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I find if you're using PHP, it's going to be your entire CPU and memory load problem, and the server in front of it isn't.

I have bothered with php-fpm previously, specifically so that when the server is getting hammered it just stops trying, instead of sending the box into OOM-killer.

Yes that is very much the case, but people are still using these things.

I think mostly because they don't know better.

It's mostly because it works for them and is good enough, so there's no strong motivation to change, especially when the old approach is so well-understood.

I have not followed Perl web development lately, but 10 years ago people were moving from mod_perl to FastCGI.