An old man gets hit by a car. He’s lying in the street and a woman runs over and puts her coat under his head. She asks, “Are you comfortable”? 

He replies, “I make a living.”

I’m here all week folks! Jokes aside, are YOU comfortable? Do you make a living or do you make a fortune? Who decides the difference? One person’s comfortable life is another’s bare existence. It’s all relative and it’s all personal. Which is great. I totally support everyone working for the resources they need to achieve their definition of comfortable. However over-the-top it may appear to you. Or do I? Is there a point at which it’s not really understandable, much less realistic and necessary? The answer is yes, but I doubt we’ll reach a consensus on what that point is. OK, actually we can. No one, and I literally mean no one, thinks Elon Musk needs or should have that much money. So why does he do it? I think a lot of us have been disabused of the notion that he does it to better mankind. And it’s too easy to say it’s greed, a word that covers a lot of ground—and motivations. It’s more complex than that and often comes subtly wrapped in less pejorative terms. 

I work with and have met a number of people who chase the dollar not because they actually have a plan for it, such as a bigger house or a nicer car, but because they can. That, or they feel the need to. It’s that act of achieving, of raising the bar over and over again. It’s the pursuit itself that has enthralled them. In addition to a sense of accomplishment, they get a high. I would posit this isn’t entirely unlike a drug high. It’s a short-acting one that drives them to repeat and repeat. It’s the finance version of cocaine. It’s a phenomenon that seems to occur in a subset of people where the more money they have, the more they have to have. 

People of modest means work hard because they have to, to pay their bills for starters. They may like their work, or they might like to work. At more stratospheric income levels, relatively speaking of course, it takes on a life of its own. Or, more correctly, it owns its owner. Again, like an addiction. It’s an addiction to the process and the feeling it brings. It doesn’t bring satisfaction, but a high based on an abstract concept. 

I probably shouldn’t be so demeaning of feeling “high.” Or of extreme happiness either. We all should be chasing the latter. If constantly pushing to make more and more money, to accumulate more and more wealth simply for the hell of it makes you feel that way, why should I care? Because, as with drug addiction, it takes over your life. It changes you in ways obvious and subtle. It makes you care less about the world around you and more about the world inside you—your head, your needs. It’s not pretty. It can be tough for that person to see that part of themselves, see how that colors their personality and their interactions with others. Many years ago I had a couple of friends who developed a meth addiction. They thought they were in control, that it didn’t make them bad or less-civilized people. But it did. They were clueless. And while the analogy may be perhaps a tad over the top, some people who are consumed with winning every last dollar because doing so makes them feel good aren’t that dissimilar. They can cloak it in their dedication to capitalism. Or exceptionalism. Or they may call it a reward for working harder than everyone else. And it may be, in part, a little of all of that. However, it’s often more abstract and instead it becomes a game of chasing a carrot they will never get. 

Dr. Blecher is an attending surgeon at Wills Eye Hospital.