-e- especially the necessarily stressful part of this role.
Can happen at companies of any size.
Impact (on others, on myself permanently) correlates very well to stress for me.
High impact decisions cause more stress: getting a project defunded, letting go of people, critical mistakes in execution that cause the company reputation or finance damages, etc..
At the very far end are life and death decisions that impact others and the very low end day-to-day decisions that only impact you (what tasks to complete, what shoes to wear).
With the above framework, it's unlikely highly paid Googlers made low impact and thus low stress decisions.
Then after still achieving nothing, you get nice ratings on your performance reviews, and then you realize that barely anyone is actually having any real impact. There is an enormous organ you are attached to that absorbs money to write fluffy annual performance reviews.
Then you eat ice cream in the nap pod hoping that you can feel content with your extreme comfort, but the most meaningful change in your mental state is a mild brain freeze.