>do any of my hard work actually matter?

Yes... basically in life, you have to find the definition of "to matter" that you can strongly believe in. Otherwise everything feels aimless, the very life itself.

The rest of what you ponder in your comment is the same. And I'd like to add that baselines shifted a lot over the years of civilization. I like to think about one specific example: painkillers. Painkillers were not used during medical procedures in a widespread manner until some 150 years ago, maybe even later. Now, it's much less horrible to participate in those procedures, for everyone involved really, and also the outcomes are better just for this factor - because the patients moves around less while anesthetized.

But even this is up for debate. All in all, it really boils down to what the individual feels like it's a worthy life. Philosophy is not done yet.