Many of the top companies you know were that healthy company once. You basically need to be one at that magical inflection point where the growth will crush you if your engineering is not empowered and on point. Especially back when clouds didn't exist, or were far less featureful, so turning dollars into horizontal growth was not a thing.
The dark secret is that being a healthy company is just a moment, not something a company is at all times. Staying a healthy company as you grown when you are actually successful is very hard, and once the health is gone, good luck regaining it, because now you have a lot of people that thrive in unhealthy environments.
Bang on. This is why I find these other comments which amount to "work in an unhealthy company? Just don't!" to be so naive. You're only ever one departure away from a shakeup which can totally change your work environment. If you aren't equipped or prepared to play the big game, then your options are
The dark secret is that being a healthy company is just a moment, not something a company is at all times. Staying a healthy company as you grown when you are actually successful is very hard, and once the health is gone, good luck regaining it, because now you have a lot of people that thrive in unhealthy environments.