Muscle memory is the worst problem. Our son and DIL have lived in Australia for 15 years, and they still feel in an emergency situation their muscle memory from driving in the US might take over. (It hasn't yet, but they've caught themselves about to experience it.)
If you are renting a car, consider that in a manual transition car, you will be working the gearshift with your left hand. Pedals are the same as the States. Renting an automatic is usually more expensive but worth it.
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It's harder to hate close up.
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