Laurencewill,
I'll take a jab at the splinter in your brain --
It's all about people having enough imagination to think about what they really want to do in their lives. Work becomes like an addiction, a crutch, a choice unconsciously or consciously made because it's too hard to peer through the fog and figure out what you'd actually do with your life if you had it back. Or too scary to contemplate.
Of course people who have figured out the ER way of life, and are just needing some more years to work the plan, are exempted from this description.
THere is another point, though, too. Work isn't always dreadful, in fact sometiimes it can make you feel like you are accomplishing something useful and satisfying. So some people hang in there working looking for that feeling. I think even ERs can have some of that feeling with a carefully chosen paid or unpaid avocation.
One other point -- I used to be aware that I would overspend on vacation and come back to work feeling, "at least I know why I'm here this month -- to pay for all that vacation", and it somehow seemed to take my mind off what I didn't like about being at work. Sort of like a co-dependency or something -- more and more I think of the work-and-overspend thing as a national addiction.
ER's have looked the beast in the eye and said, 'no thanks'.