Category: Rants

It makes sense that people around the world can enjoy occasional America-bashing; god knows we make it easy for them. We export the worst parts of our culture – fast food, corn syrup beverages, idiotic entertainment, Jerry Lewis – around the globe, we still have a strict policy of American Exceptionalism in global affairs, we have an unpleasant tendency to start wars, and (worst of all, in my opinion) a large number of Americans know absolutely nothing about the world outside our borders. Many people around the world no doubt conceive of Americans as the stereotypes that some of us work so hard to deserve: as anti-intellectual, violent, proudly ignorant slobs who eat KFC every day and drive pickup trucks.

When I read non-U.S. news sites it's hard to miss the occasional "Look at how barbaric Americans are" stories, usually focusing on gun violence, racism, our failing healthcare system, or the latest can-you-believe-this-shit proposal from some Republican state legislator. Part of the reason that people in one country look down on another is to distract from their own problems, but there certainly is a ring of truth to these criticisms. Like I said, we do make it easy for anyone who wishes to paint us with a broad brush. It would be silly to take it personally or to point out the bleedingly obvious fact that stereotypes do not describe all members of a group accurately.

The one and only thing that bothers me is the accusation that America has a race problem.
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The smugness in some of the foreign coverage of the Zimmerman trial, for example, was palpable. We do, of course, have a race problem. But here's the thing: the planet has a race problem. I'd argue that racism, be it institutional, social, or held by individuals, is a bigger problem in any number of places than it is in the U.S.

Recently Italy made the news when some right-wingers threw bananas at the country's first black government minister. This borrows the "monkey noises and banana hurling" antics that soccer hooligans have been using for years on black players. Domestic politics in the EU – from Russia and Eastern Europe to Germany and Spain – are often tainted with xenophobia and racism. Ethnically homogenous societies in Asia – particularly Japan but also Korea and China – are hardly good role models. Watch a big sporting event in any South American country and you see the exact same "Everyone in the seats is white, everyone on the field is black" dynamic that you see here.
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My point is not that the criticism of the U.S. as a place with a race problem is unwarranted. Rather I'd caution people in other nations from giggling at our Zimmerman trials and Rush Limbaughs with an air of superiority. Maybe stick with mocking us for believing that climate change is fake, at least until your society addresses its own issues with racism, nationalism, and xenophobia. We're not exactly alone in having those tendencies both individually and collectively.

Several summers ago I contracted two relatively rare infectious diseases at the same time…and right on the tail end of a long bout with mononucleosis. Despite being what the medical profession would consider Young and Healthy at the time (I believe I was 27) the one-two-three punch did a good job of overwhelming my body. At one point I was checked into a hospital with a fever of 105.2 F (40.6 C), which, in medical terminology, is balls high. Had I been very young, very old, or immunocompromised, the phrase "life threatening" would have been used.

For all the flaws of the American health care system, one thing it does pretty well is avoiding the overuse of antibiotics to prevent resistance from developing among infectious agents. Actually, it prescribes some of the common antibiotics (amoxicillin and other penicillin derivatives in particular) like candy. Azithromycin is a first-line treatment now for things as common as strep throat. But the formidable antibiotics of last resort, the "You can have this if you're about to die" drugs, are used more judiciously.

If common sense doesn't dictate this, cost does. I was finally given a course of vancomycin, a staggeringly expensive former last-stand antibiotic. After a few decades, resistance developed and it is now used as an intermediate step between common antibiotics and new "Oh shit" drugs like Zyvox. To skip forward to the very obvious ending, I didn't die.

Vancomycin had a good run. Its four-figure per-dose cost helped doctors ration it and lower the odds of resistance developing. But pathogens will develop resistance to any drug if given enough time, which is why pharmaceutical companies are constantly hard at work on new antibiotics, antivirals, and antiparasitics to stay ahead of the emergence of new infectious threats.
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Wait. What I meant was, pharmaceutical companies don't do that at all. I apologize for the confusion.

Nature is shining the spotlight on the development of bacteria that are impervious to the current drugs of last resort, the carbapenems. If penicillin and chicken noodle soup are the Maginot Line against infections, the carbapenems are Dunkirk without the ships.
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If the carbapenems don't work, medical science can't kick it up another notch. The next step is prayer, and after that is death. Help is not on the way:

It seems unlikely that new drugs will become available soon. Perversely, the rapid advance of resistance and the consequent need to use these drugs sparingly has convinced pharmaceutical companies that antibiotics are not worth the investment.

The Nature piece is well-timed, as I was just having this conversation with a biologist-friend a few days ago. In it I was stunned to learn that, no, Big Pharma is not hard at work on the next wonder drugs. It turns out that there isn't much money to be made from antibiotics, and until recently it seemed like the extant options were working pretty well. Additionally – and this is far beyond my level of knowledge to judge – developing novel antibiotics is challenging. Certainly it's more challenging than the alternatives. The cost-benefit ratio does not support large investments in antibiotics.

Thanks to the glories of our free market, for-profit medical-pharmaceutical complex, we may not have any new antibiotics but we have plenty of new Magic Dick Pills, weight loss drugs, statins (Eat whatever you want!), indigestion remedies (And eat all of it!), chemical means of growing and removing hair, and a prescription drug to treat the scourge of insufficient eyelashes. By leaving the industry to its own devices we are guaranteed the absolute best possible treatments for our most profitable lifestyle diseases. Meanwhile, government research money is directed toward drug treatments for the medical conditions with the best PR team, which is why cancer research is absolutely awash in money with almost nothing to show for it in the last two decades. Oh, and no one cares about AIDS anymore. It needs a new celebrity victim, I guess.

Meanwhile we find ourselves on the brink of a potential public health catastrophe. The invisible hand does indeed allocate the efforts of private industry to the best possible uses, as long as "best" and "most profitable" can be used interchangeably. That's swell until the medical community finds itself with some rather unprofitable and unglamorous needs, exposing the flaws in our system of entrusting the direction of medical research to the whims of an article of right-wing religious faith.

Are you happy?

If you're an American, the odds of answering that question in the affirmative are decreasing with time.
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If you're a Gin and Tacos fan, it's close to nil. But I kid.

There has been no shortage of hand-wringing since the early 1990s when the diagnosis of depressive disorders – and subsequently the prescription of antidepressant drugs – exploded. The growth of medically diagnosed unhappiness is quantifiable, to say nothing of even more depressed people who avoid diagnosis or treatment.

Not only are rates of depression high among the general public, but in certain populations (the elderly, young adults, etc) it is nearly epidemic. This might say more about the company I keep than anything else, but sometimes I wonder if I know anyone who isn't on antidepressants or hasn't been on them at some point. The prescription for Cymbalta or Lexapro seems to be as popular among twenty- and thirty-somethings as PBR and Breaking Bad.

Doctors recognize a range of causes, from biological to social to psychological.
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There is no single reason people get depressed, but many. Some of the risk factors are things that are becoming less common; others are on the rise. One that I've been thinking a lot about lately is, as the DSM states, "feelings of helplessness and pessimism." It is not hard to imagine why a sense of helplessness could lead to general depression.

In the last thirty years, Americans have dramatically increased the number of reasons to feel helpless. Especially in terms of economics, how many of us really control our own fate these days? Young adults leave college (with loads of debt) to enter a job market and economy that, through no fault of their own, might leave them unemployed. Older working people have seen the protections that Americans once took for granted – labor unions, non-toothless enforcement of labor laws, general job security – radically scaled back as well.
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Employers, and the political-economic class as a whole, relish in emphasizing the lack of job security that defines the modern economy. No long term contracts, no pensions, no job security beyond day-to-day – we're nearing a full return to the At-Will Utopia that the Robber Barons of the 19th Century once enjoyed. The only right you have is the Right to Work. No matter how hard or well you work, your job may one day disappear to Mexico or India or some other low wage nirvana.
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In my field, I often hear the Old Timers tell tales of job hunting in the 1970s when interviewing was more about the school convincing the applicant to work there rather than vice-versa. Even the most ordinary candidates could expect multiple job offers. Today, even the most excellent candidates often find themselves without one. This is no different than most other professions – I'd bet that whatever line of work you do, the number of applicants vastly outnumbers the available jobs these days. Combined with the constant threat of offshoring in the post-NAFTA world and the average American finds him- or herself feeling professionally powerless. Helpless, even. We find ourselves at the mercy of forces beyond our control. We have little power and little choice over where we live, what working conditions we will accept, and what wages/benefits we receive.

That is, of course, exactly the way They want it. Some people benefit tremendously from this state of affairs. Most of us do not.

When we see news stories and commentaries about tens of millions of prescriptions for antidepressant being written annually in this country – other industrialized nations are catching up, too – economic and political conditions rarely enter into the discussion. But is anything more depressing than being unhappy with your situation and powerless to change it? We've successfully transitioned to a nation in which "If you don't like it, there's the door…and good luck finding anyone else who's hiring" is the zeitgeist and elected officials (from whom we are completely alienated by a system that auctions them to the highest bidder) make decisions that degrade your working conditions, job security, and chances of finding employment at all. Whatever skills or profession we have, our sense of control and agency have eroded. Can anyone be surprised that so many Americans feel hopeless and turn to drugs – from a doctor or otherwise – to cope with the growing sense that we have no control over our own economic fate?

The Scottish legal system is unique in that it offers juries three verdicts: guilty, not guilty, and not proven.
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The third, often referred to in legal circles as a "Scottish verdict", implies that judge and jury are not convinced that the accused is not guilty but there is insufficient evidence to prove guilt. Given the paucity of eyewitnesses and the disputed nature of what little evidence existed aside from the defendant's statement, the Zimmerman trial appeared from the very beginning to be headed for a Scottish verdict. The state simply was unable to prove beyond a reasonable doubt that the confrontation was initiated by Zimmerman and not Martin. In that sense, the verdict is unsurprising.

A great many proud centrists, Very Serious People, and secretly-elated observers on the right have sought refuge in the argument that "Everybody lost.

" While it is true that Mr. Zimmerman will suffer extrajudicial consequences, this statement is as insulting as it is facile. It is hardly splitting hairs to note that while everybody lost, the person who died lost quite a bit more than the one currently at home on his sofa.

In the larger sense this incident and trial are a glimpse into the endgame of the last four decades of gun politics, the logical result of a mindset that sees threats everywhere and believes that the Constitution guarantees each individual the right to respond to those threats, real or perceived, in any manner he sees fit. We insist not only that we have the right to be armed at all times in whatever manner we choose, but also, with the proliferation of "Stand Your Ground" laws, to be the sole judges of when using our arms is appropriate. In other words, the death of Trayvon Martin is exactly what is to be expected from a culture that arms every numbnuts who can afford a pawn shop pistol and believes that those same people are qualified as judges, juries, and executioners. "Feeling threatened" is the only requirement that must be met to justify a death sentence; if one happens to feel threatened whenever a black male is within 50 feet, so be it. We must allow each armed would-be vigilante to make that choice, because Freedom.

That, really, is at the heart of this incident: would a jury agree that being black, male, and hooded is sufficient to arouse suspicion?

Even if that suspicion initiates a sequence of events that ends in death?
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If you weren't sure if the (all-white) jury would buy that argument, a refresher on the American judicial system might be in order. This has long been a society – including the courts – that considers some lives more valuable than others. The right to feel safe and secure in one's person and property has been particularly sensitive to the rankings of the social hierarchy over time.

That is why we create an ever-larger class of people walking around with guns – because our (mostly white, mostly male) courts and legislatures recognize how important it is for this (mostly white, mostly male) group to feel safe. If it so happens to make everyone else – black males, women, etc. – feel less safe, so be it. Every black male in America leaving his house wondering, "Is today the day I get shot for having my hand in my pocket?" is, legally and socially, a small and justified price to pay for the greater sense of security that carrying a concealed weapon provides insecure white people.

The biases of the legal system, like the society it reflects, are deeply ingrained. No one sits around rubbing his hands and chuckling, "Let's kill us some black guys!" like a Hanna-Barbera cartoon villain. It is a quiet, persistent, passive bias that enables things like this to continue to happen. It is every judge and jury that accepts without question that black male, especially when dressed In a Certain Way, is suspicious and threatening. It is every example of the benefit of doubt being given to the shooter in instances of self-defense, as though "self defense" is a well-defined concept independent of the judgment, prejudices, and irrationality of the shooter. It is everyone who insists that "It's not about race" to assuage their own guilt, irrespective of the fact that a similar verdict with the racial roles reversed could scarcely be imagined.

If you've shopped for or purchased a new car, you notice that window stickers are a decent source of unintentional hilarity. In an effort to make each car seem as feature-laden and fully loaded as possible, manufacturers will often list items so basic that no car could be sold without them. Steering wheel. Bumpers (front and rear!) Radio. Windshield wipers. Cupholders. It's certainly fair to point out that the car has these amenities, but as a consumer, you're interested in what the car offers beyond the bleedingly obvious.

So that's what car dealers emphasize. You already know it comes with seat belts and a dashboard, so the dealer is going to sell you on satellite radio and rear view cameras. To do otherwise would be suspicious. Let's put it this way: if their sales pitch is "This car has a windshield!", as a consumer you would assume (justifiably, no doubt) that this is a pretty lousy car.

I think of this example every time I receive a pay stub. My current and most recent former employer both embraced the new "management theory" trend of giving employees lengthy statements of benefits or "Total Compensation" figures.

For example, the pay stub lists not only my salary and what I pay to get health insurance, but also what my employer contributes monthly to the cost of my insurance. As the cost of health plans is quite substantial, this adds many thousands of dollars in additional income.

Er, "compensation."

In a sense, I think this is a great idea if for no reason other than to show Americans the behind-the-curtain costs of our ridiculous system of health care. In every other sense I find this practice somewhere between irritating and insulting.

When I say my employer gives me a list, I mean a list. There must be 30 things that I am told are part of my overall "compensation". This includes some items of real economic value – contributions to insurance and TIAA-CREF, for example – but is lengthened substantially by things of minimal value (discounted tickets to university sporting events?) or almost none (free notary service!) Most irritating are the things that one cannot avoid having on a university campus – e.g., use of the library or rec center.

The university must have these facilities. Allowing me to use them costs my employer absolutely nothing. How does this constitute "compensation"?

I object to this practice because it is little more than a smoke-and-mirrors trick employers are now using because Americans have finally begun to notice that their wages – you know, the actual money we get paid – hasn't changed in the last few years. Statistically, adjusting for inflation real wages have actually fallen for most Americans since 1970. These statements of benefits are intended to (over) compensate for the semi-annual "By the way, unfortunately there is no money for raises this year" letters and emails. You're not getting a raise, but look at how much we already pay you. It's way more than just your salary – it's also free use of the university parking deck on weekends!

Stop complaining already, you ingrates. Look at how much we do for you. It's almost admirable, the amount of the balls it takes to pursue a strategy of telling employees, "You don't understand your own compensation" in salary negotiations, as if landlords and banks will accept free library checkout privileges in lieu of cash.

White people across the nation spent the weekend resting their sore knees after a busy week of taking turns kicking Paula Deen in the ass to prove thoroughly, appropriately repulsed they are by the very idea of racism.

Before we go on, I have to admit that I hate Paula Deen in ways that defy description. Her fake-ass accent, her insufferable cokehead kids with their spinoff shows, her shameless hawking for labor/animal abuse superstars Smithfield, her "Ain't heart disease and obesity hilarious!" cooking style, and her paid shilling for a diabetes drug when her daily butter intake finally caught up with her…
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she's just a disgusting human being all around. That she apparently held and/or holds racist tendencies is neither surprising nor, in my case, a reason to think less of her. I really can't think less of her without getting to know her and adding some sort of personal component to my loathing.

That said, it's hard not to feel like we're going a bit overboard here. I would rather Food Network fire her because her show is an appalling trainwreck – like Divine from the John Waters films making a dessert buffet for a live in-studio meeting of the Daughters of the Confederacy. I would rather she lose endorsement contracts because the lifestyle she promotes is disgusting. I would rather her book contract be rescinded because her books are garbage aimed at morons. I would rather the public turn on her because she's a grating, cloying, parody of the worst things about America. All of these seem like worse offenses than an admission under oath that she used the word "nigger" thirty years ago.

Yes, I find that offensive too, and I have no sympathy for her.
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None. If it cost her a job, endorsements, and other opportunities, she has no one to blame but herself. But is it necessary for us to howl until she's burned at the stake for what happened? As Jimmy Carter said, "I think she has been punished, perhaps overly severely, for her honesty in admitting it and for the use of the word in the distant past.
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" And as Jesse Jackson Sr. said, "She should be reclaimed rather than destroyed." Perhaps the problem is that Deen is so generally unlikeable that we're merely seizing on this as a reason to crap all over her. But it sure seems like some of us are using vehement, public condemnations of her actions as a means of allaying guilt – "I'm glad they got her and not me."

Screw Paula Deen. I'm glad to see her fail. Can any of us, though, say with a straight face that we've never thought or said things that are offensive? Racist? Homophobic? Sexist? We all like to say "Yes, but that was in the past, I've changed. If the rest of us can fall back on that, why not Deen?
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Maybe she used to talk like that but no longer does. Maybe she still does. Who knows. The point is that the Downfall of Paula Deen strikes me as a case of the right thing happening for the wrong reasons.

This is a few months old, but I can't always stay on top of the latest from monthly magazines in Australia. An Aussie doctor and writer offers a frank, sensitive, and comprehensive take on increasing rates of obesity and why we shouldn't expect doctors to fix it. It's long, but please read it before venting.
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By classifying obesity as a disease that implies that there are things doctors can do to cure or treat it.
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However, the doctors' tools are quite limited:

A recent New England Journal of Medicine article dealing with the rise of chronic lifestyle-driven diseases calls for a change in the way physicians think about their patients. The author suggests that medical students should be taught to be less reductionist, to learn how psychological, social and economic factors all act as determinants of disease. I do not know what medical school is like in the US, but even our surgeons – the most hard-arsed of doctors – sit reeling before the tragic combinations of circumstance and choice that lead our patients to weigh two or three (or four or five) times what they should. The doctors I work with have an excellent grasp of the bio-psycho-social factors that contribute to our patients' states, but we are only doctors. All we have are the tools of our trade: our ears, our voices, our hands, our pills and our scalpels. The waiting rooms are full, the waiting lists are long, the demand is swelling. Obesity is in many ways the logical endpoint of the way we live. Prevention beats palliation, but we'd need psychologists, motivational speakers, social workers, dieticians and physiotherapists to work with us in order to have any hope of tackling the problem. We’d need policy makers and activists. All we have are doctors like me.

In the absence of a holistic, comprehensive approach, we have doctors telling patients what they already know ("You should lose some weight!") and making them feel shittier than they already do. What we run up against, she suggests, is the reality that food has become a singular source of pleasure for a lot of people.

I ask a young 200-kilo patient what he snacks on. "Nothing," he says. I look him in the eye. Nothing? He nods. I ask him about his chronic skin infections, his diabetes. He tears up: "I eat hot chips and fried dim sims and drink three bottles of Coke every afternoon. The truth is I'm addicted to eating. I'm addicted." He punches his thigh….My patient is not addicted; he's a very lonely, unemployed young man who has gradually become socially isolated to the extent that the only thing available to him for comfort and entertainment is food. He has no friends, no money to buy other consumables, little education, no partner, no job. Some days he doesn't leave his bed. The choice for him is to eat this food or experience no pleasure.

And then, the kicker:

This is where the obesity-as-disease concept leads us – to a situation in which people demand that medicine shoulder the responsibility. What about the responsibility of the individual? And of society? My patient cries because the highlight of his day is returning from the supermarket with a plastic bag full of junk that he will eat and drink in his empty lounge room. What can I do for him? I can threaten him with his early demise, intensify his shame. I can offer him some evidence-based motivational lifestyle interventions – swap Coke for Diet Coke! Prescribe exercise? Walk for an hour at an average pace and you'll only burn off the equivalent of one slice of bread. I could take the old-fashioned approach and wire his jaw shut. I have no hope of resolving his loneliness, his hopelessness, his lack of a job. I could, and do, refer him to a psychologist – if he's lucky he may land one who is talented and sensitive and will try to get to the root of why this young man hates his own guts. More likely he'll be offered a few sessions of behavioural therapy that will make everyone except him feel better.

This hit me. I've been here.

I haven't been 200kg (440 lbs), but I've been through periods of my life in which eating was the sole thing I had to look forward to for days at a time. When you move to a new city, live alone, know no one, don't have many options for entertainment, and have some food/eating issues to begin with, it doesn't take very long at all for the pint of ice cream or the bag of Doritos or the candy bar to become the highlight of your day. It's the only thing that offers any pleasure. There's no one offering you a back rub before bed, no post-work happy hour with friends, no parties on the weekend, no frolicking outside on a sunny beach. There's food. There's work, dreary gray skies, frigid winters, and food. And that food is cheap – especially shitty food. If I want to do something I will get actual pleasure from, I can pay $75 for an hour massage or $2.99 for a bag of chips that will take me 45 minutes to eat. I can spend $400 on plane tickets and travel to visit friends somewhere, or I can spend $15 on pig-out food for Friday through Sunday.

That's the problem. That's why doctors can't help patients beyond giving them advice they've already heard, pills/surgery that won't work unless they change their eating habits.
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As the writer states, every "diet" that works amounts to the exact same thing: eat less, and stop eating so much garbage. We get it. The problem is actually doing it. We expect the doctors to "treat" the problem within an entire system set up to encourage it – a depressed and depressing economy, a trillion dollar fast food/snack/beverage industry and its refined marketing techniques, an agribusiness lobby that dominates the institutions of government, and a decreasing number of ways to connect meaningfully with the people around us.

Shockingly, doctors have yet to discover a pill that fixes all of that.

"Lisa, if you don't like your job, you don't strike. You just go in every day and do it really half-assed. That's the American way." – H. Simpson

Recently, a relative was telling me how disappointed she was in the school her kids (used to, but will no longer) attend. It seems that at this private Catholic K-8 the teachers threw in the towel with about a month to go in the school year.

The majority of May was filled with the kinds of things K-8 schools/teachers do when they want a day off – parties, Movie Days, assemblies, etc. The kids were having multiple "parties" per day to celebrate, well, anything the school could think of. The music teacher devoted two entire weeks to showing the students Toy Story…twice (??). In short, she told me that many parents were very upset, feeling that they had paid for nine months of classes and had barely gotten eight. Being a Catholic school, the tuition is not an inconsequential amount.

I sympathized. She told me tale after tale of things the school used to fill the days with anything but lesson plans and actual academic activities and her anger made sense to me. Not trying to stoke the fires or start a political debate, I just noted that this was not rare at any level of education, but was particularly common in private schools. Catholic schools are known for paying less than dick, so in this situation the kids are in the hands of teachers who haven't gotten a raise in 15 years and who were getting paid poorly to begin with. It doesn't surprise me, I pointed out, that in a situation like this people might go out of their way to do as little work as possible. When a job devalues employee, literally and figuratively, their response is often to work just hard enough to avoid getting fired.

The losers, of course, are the students. The parents are right to be angry, but I understand the mindset of the teachers. They are rational, and if the job isn't paying then they will seek to improve their lot by making the work easier. And nothing's easier than not teaching. I don't think she found this explanation persuasive, and I didn't push it. But it raises a larger question that I think about often: how hard do we have a right to "expect" people to work?

Even though many people can and do complain loudly about poor service, deep down I think we all understand that the kid at Taco Bell makes minimum wage, doesn't give a shit about the job, and isn't exactly going to go at 110% every single day. But how "hard" is a teacher supposed to work? Is he cheating you if he re-uses lesson plans rather than coming up with brand new and up-to-date ones every year?
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Is your doctor cheating you if she runs a test and diagnoses you rather than running all of the tests and spending hours reading about every possible thing that might cause your symptoms? Is your pilot lazy because he uses autopilot? Is your waitress lazy because she hasn't refilled your coffee as many times as you might prefer?

People are judgmental. Combine that with the fact that we pay for things (using the money that we have made our own sacrifices to obtain) and expect to be satisfied, and commenting on the work ethic of others is practically a national pastime. The previous thread on pensions noted that some people seem to think they invented the concept of hard work – nobody but me has even done an honest day's work! Some people certainly do have that attitude.

But often the complaints people make (as in the story retold above) are valid. The part I can't figure out is what to do about it. No employer is going to raise the salary of employees who clearly half-ass their jobs, yet if the compensation is low most people simply aren't going to work very hard.

From the teachers' perspective, what is the motivation to work 16 hours per day and move heaven and Earth to be the best teacher since Jaime Escalante if they get paid the same $31,000 per year for being…mediocre? Business schools have spent 30 years churning out people who believe in motivation by intimidation – work hard or else we will fire you, replace you, move to Mexico, and so on. And yes, an employer certainly has a right to expect employees to fulfill their obligations.
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This is where we see the large gap between fulfilling the requirements of a job – i.e., doing the bare minimum – and doing a good job. "Work hard and you will get promoted / get a raise" is the natural response, but in many of our workplaces I think we discover fairly quickly that the raises aren't coming no matter how hard we work (or they come, but with a truckload of additional burdens that vastly outweigh them).

That's the end result about all of this "Woe is us" from the owner and manager classes – we're constantly told that we can't be paid more ("We just can't afford it! We're barely breaking even!") but we're not expected to react strategically. The rational thing to do, if you know you can't profit from working harder, is to figure out the minimum amount of work you can do under the terms of your employment.

Of course, when certain people in our society do what is rational, it's "smart". When the rest of us respond rationally to incentives, we're lazy.