For a story that was filled with largely mundane descriptions of workplace practices at a large technology company, a recent New York Times feature on Amazon AMZN has touched off a raging forest fire of responses. Why? Is it because so many people care about how white-collar middle managers are treated at an online retailing company? That seems unlikely.

I think it’s because the article tapped into a deep-seated, almost existential fear that runs through many of our lives — not just in the technology world, but elsewhere too: Namely, the fear that the ways we work now are harming and/or killing us.

I don’t mean harming or killing in the same way that policemen and women are harmed or killed in the line of duty, obviously, or people who handle hazardous chemicals, or aid workers in war-torn countries. The damage that can be done by workplaces like Amazon’s is much more insidious, and difficult to detect — and when people die, their obituary says things like heart disease or stroke or suicide.

Increasingly common

Part of what I tried to get at in my first post about the New York Times piece was that Amazon isn’t all that different from many other successful technology companies, such as Apple or Google or Facebook. And it probably isn’t that different from what many people experience in other areas, such as Wall Street or sports or the military. That doesn’t mean it’s good, it just means that it has become increasingly common. But what kinds of things are we accepting as part of that bargain?

The NYT piece — along with other reporting about Amazon by people like author Brad Stone, in his book “The Everything Store,” — describes people sleeping in their cars in the company parking lot, or not sleeping at all for days. It talks about them working evenings and weekends as a routine, avoiding their families and friends and any semblance of personal time, subjecting themselves to unimaginable levels of stress in order to get ahead or achieve some workplace goal.

As many supporters of Amazon and other Silicon Valley companies have pointed out, many people do this kind of thing willingly. They do it because they are committed to a cause, or because they believe they are part of something larger than themselves, and because they enjoy a challenge — just as many people enjoy running marathons or climbing mountains. What’s so bad about that?

Of course, just because someone does something willingly doesn’t mean that it’s good for them. In many cases, we are drawn to behavior that is bad for us, and that arguably applies to the workplace as well. In a piece he wrote for Medium recently, Facebook co-founder Dustin Moskovitz talks about the early days of the company and how he slept little and ate badly, and was hyper-competitive with co-workers. Was this worth it because of what they accomplished? Not at all, he says.

Better off

In fact, Moskovitz — who now runs a startup called Asana, where he encourages his employees to have a better work-life balance — not only argues that he personally would have been better off if he hadn’t worked so hard, but that Facebook FB itself would have been better off as well. That’s because he believes that many of the aspects of his behavior that were allegedly driven by a desire to succeed actually made him worse at his job and likely held the company back.

“I believe I would have been more effective: a better leader and a more focused employee. I would have had fewer panic attacks, and acute health problems — like throwing out my back regularly in my early 20s. I would have picked fewer petty fights with my peers in the organization, because I would have been generally more centered and self-reflective. In short, I would have had more energy and spent it in smarter ways.”

It’s not just feeling unhealthy or missing out on experiences with family, where the psychological impact is difficult to quantify. There’s research that shows high stress work can actually kill people, by driving up levels of heart disease and making strokes more likely. And that’s on top of health impacts like repetitive strain injury (RSI) or back problems, or migraines and other issues.

What I think made the New York Times story resonate with so many people who don’t work at Amazon is that they can see aspects of this in their own lives: They have a cellphone that allows them to be contacted in a variety of different ways — phone call, email, text message, Slack chat room, Google Hangout, Twitter DM, etc. And since that technology is widely available, everyone in a certain type of job is expected to have it, and as a result they are expected to be available at all times.

Those expectations often filter through gradually, as a result of other kinds of behavior. Who gets a promotion or a raise? Who gets singled out for praise during a meeting or an off-site get-together? Whose proposals get the most buy-in, and whose get ignored? If recognition goes to the person who works nights and weekends and never takes vacation, what message does that send?

A vicious circle

In some respects, this problem turns into a vicious circle. The people who get promoted do so because they sacrificed their health and/or personal lives, and therefore the incentive to favor similar kinds of behavior is increased. A recent piece in The Atlantic put this well:

“One of the reasons that this [culture] has proved so unbelievably difficult to change is that the winners of the system are the breadwinners who saw very little of their children. It’s an identity-threat situation; they have an incredible amount invested in proving that’s the only way to be a professional. Because, if it isn’t, why did they do it? How come they don’t know their children?”

We see the impact of this kind of process in all sorts of ways. Many technology companies have taken to offering what they call “unlimited vacation,” which theoretically allows anyone to take time whenever they wish, without having to request it or book a specific amount. And yet, many surveys (and actual experience) show the vast majority of people never do this, and in fact wind up taking much less vacation than they would otherwise, because they don’t want to be seen as slacking off.

Is there a way out of this cycle? Can we somehow have all the productivity and efficiency gains that we think come along with this kind of workplace lifestyle, but at less personal cost? Moskovitz thinks we can, provided we start looking at the real costs of our work — that is, the long-term impact on employees and their ability to contribute meaningfully — rather than just doing the math on short-term metrics like revenue per man-hour, etc. And maybe that’s where founders like Amazon CEO Jeff Bezos can make their biggest contribution to improving our lives.

You can follow Mathew Ingram on Twitter at @mathewi, and read all of his posts here or via his RSS feed. And please subscribe to Data Sheet, Fortune’s daily newsletter on the business of technology.