Yeah, I don't get why people find the one-way streets all that confusing, either. There are two big ones that run the entire width of the city: King Street goes west, Main Street goes east. At the far eastern and western ends of the city, each also becomes two-way. Some of the major north-south streets were actually converted from one-way to two-way a couple of years ago (James St. and John St.), with mixed results - Hamiltonians tend to love their one-ways.
Aside from those, as you pass through downtown, the north-south streets kind of alternate between one-way directions. So if you can't turn a particular way down one street, you generally just go to the next one, and you can. So really, it's not a big deal (I'll also add that, outside of downtown, the one-ways are pretty much non-existent). I agree that Montreal is FAR worse, and don't get me started on downtown Toronto, where it seems that at every intersection you can't turn either right or left :p
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