Is there some effective way to deal with your database queries of which I’m not aware? I’m coming from a Rails background, and it seems like writing all the sql by hand is radically inefficient.

There's HoneySQL, and SQLKorma, which both do clojure->sql rewriting, but they're mostly just DSLs that compile to SQL. I'm working on a postgres-as-nosql library, because I have ... problems.

Toucan does some generic ORMish sql-generation.

there's walkable that uses Datomic pull syntax https://github.com/walkable-server/walkable