There are 253 million Internet users in China alone. What happens when your site needs to scale from 0.001% of them using the site simultaneously to needing to scale to 1% of them using the site simultaneously? Within a month?
"Of course if you index poorly or create some horrendous joins"
Which in the Twitter and Facebook cases is exactly what they have to do on many of their requests. As I've personally found out, relying on a database to do a join across a social network graph is a recipe for disaster. One day you'll be woken up because your database's query planner decided to switch from using a hash join to doing a full table scan against 10s of millions of users on every request. Then, you'll be left either trying to tweak the query plan back to working order, or actually doing what you should've done in the first place: architect around message queues and custom daemons more suited to your query load.
"Even with billions upon billions of help tickets."
At 50 million tweets a day, Twitter would hit 18 billion tweets within a year. Good luck architecting a database system to handle that kind of load. That is, one in which the database system is serving all of the requests (including Twitter streams) and isn't just being used for data warehousing.
"Such a solution — even on a stodgy old RDBMS — is scalable far beyond any real world need"
The disconnect here is this guy's needs are not the needs of a lot of us who are actively looking at alternatives. He is simply not familiar with the problem domain.