The `with` statement seems similar to Haskell's `do` notation for monads, where the monad(ish) here is pattern matching.
I'm new to Elixir but I've definitely run into the "byzantine case-clause" issue and it can be very annoying. My case was very similar to the example: pulling something from a form, validating the format, validating it in the database, and returning something. All failable, single-purpose functions in sequence to narrow down the result.
I grappled between using a monad macro library[0] to simplify `{:ok, _}`/`{:error, _}` signatures versus just raising exceptions. I ended up doing the latter for the additional benefit of stack traces. Exceptions seem culturally discouraged in Elixir, though I don't quite grok why yet.
Out of curiosity, would you be willing to show how you might refactor the post's "create_organization" example?