Bookbinding is a difficult profession. It costs a lot of time and money to attain the level of craftsmanship necessary to do anything well. Being an obsessive perfectionist is not an absolute requirement, but it helps.
Then there are the artists who have chosen bookbinding as their preferred medium. It is a bit perverse of them. The level of craftsmanship, the depth and breadth of the knowledge of structures and materials that they must achieve before they can begin to create art in codex form is astounding. Combining all of that knowledge to imagine and create new tools, new structures, new techniques, and use unusual materials with which to express themselves is something few can do. Even then, not every binding is a success. This is true of art in any other medium.