Informal assessment here, re: how these versions of "hustle culture" have played out. First, people who can last a long time do make a lot of money. Second, the wipe-out rate is pronounced but not catastrophic. Yes, there's sometimes a price to pay in terms of bad marriages, early heart attacks, etc. but it's not so pervasive that everyone who chases all-out success comes up short. You can win at this game.
Third -- and this perhaps OPs best area for questioning: When you work 90-hour weeks, your judgment about picking the right projects goes to hell. You're the greyhound going round the track as fast as you can, chasing the rabbit that you'll never catch. Your rabbit-value assessment system doesn't exist. You just keep running toward whatever someone else points you toward. On Wall Street, a lot of marathon hours are spent trying to close deals that won't close. Or that turn out to have been identifiable mistakes/misguided obsessions.
I was chatting earlier this year with a former Big Law attorney who spent a frenzied year after Hurricane Katrina drafting blizzards of legal filings so that big insurers could dodge claims. Her work was valued enough that she (and her firm) got paid a lot and maybe even did landmark work. Nearly 20 years later, is that the career badge that you'll always feel good about?