I was thinking more about this. The conceptual error here is that in both (idealized) cases of the car moving and staying in place on a hill, if the engine is moving at the same RPM the mechanical efficiency of the *engine* is exactly the same- the crankshaft turns at the same rate. The essential difference here is the power loss due to the *transmission*.
In the body, the situation is qualitatively different. First, the mechanism by which *usable energy* is extracted from food is very different: a Cal of food energy is not really comparable to a Cal of gasoline. For one thing, the body converts the raw food energy into another form of energy and stores it.
And I still maintain that biological organisms are highly efficient, much more efficient at doing this, than internal combustion engines.
Now we have the transmission- how that usable energy is converted into mechanical work. Much like a transmission, muscles have a range of operating conditions- constant tension, constant force, constant length, etc. Muscle contraction is significantly more complex than a transmission, but even so, various stages along the energy transduction pathway (the F1F0 ATPase molecule is a 'battery' that charges
mitochondria, for example) are again significantly more efficient than engineered motors. By the time we get to the actual motion of a single molecular motor on a filament, the overall efficiency approaches 40% or so, and it's not clear how to incorporate concepts like 'stall'.
The OP already knew that "work != exertion". The fault is the limited definition of 'work'. Surely, there are chemical analogs available- chemical engineers know how to keep a reaction proceeding at a maximal rate, for example.