throwaway-fjobs

Just out of interest, knowing these people personally: what are the kinds of tradeoffs involved in these jobs that pay so extraordinarily well so early in one's career?

Is it a case of spending your 20s 8am-10pm in the office, no weekends, no vacation, etc?

Or, if not, then what's the path into a job like this? Are they simply 0.00001% level brilliant people, lucky, well connected?