It's like its own separate keyboard. After a little while you know where everything is, so I can hit any of those buttons without thinking based on muscle memory. What I'm saying is, it isn't as bad as it looks. Those keys got added slowly over a long period of time. Factor in macros that activate a bunch of things at once, and it's simple.
Sleeper's Tomb (tier 3) raid fight from CoV. First attempt. We won on said first attempt, but it was absolutely the biggest bloodbath I've ever seen in EQ. We have everything down in CoV except Aaryonar and Vulak, despite our general lack of gear compared to live servers (40 mains in raid is also a large handicap). At the end of the fight I turned off hidecorpse and was shocked at the volume of corpses.