The title phrase, “What makes Sammy run?” functions as a leitmotif—repeated throughout the novel to establish both Sammy’s character and the novel’s central theme: the price of all-consuming ambition. When Sammy first appears in the novel, as a young copy clerk at the paper where Al Manheim works as a theater critic, he is literally running all the time, ferrying documents from one part of the office to another. This image later becomes a visual symbol of a man driven to reach the top of the social hierarchy no matter who or what he destroys in the process. Sammy runs in the race of life, constantly trying to beat out everyone else for money, success, and power. This idea of life as a race is mentioned throughout, with Sammy’s incredible ability to “run” faster than anyone else the key to his success. Sammy’s entire life follows this model: “Sammy Glick sprinting out of his mother’s womb, turning life into a race in which the only rules are fight for the rail and elbow on the turns and the only finish line is death” (209). The race is violent. Sammy also runs people down, breaking his father’s heart, abandoning Rosalie Goldbaum, and repeatedly using Al and his other professional associates for his own ends.