It's not really that hard, just takes a bit of juggling. Steering with your knees is a bit of a lost art.
Steering with the knees...on a 2 lane twisty country road with no shoulders and large trees growing a foot or two from the pavement...seems like a good way to need the services of a body shop, if not an ambulance too.
In high school I had a friend who could smoke, text (on a FLIP PHONE), and drive a manual at the same time. He had a VW Golf.
We stuck a whistle in the tailpipe as a prank. It was there for a couple of weeks before he realized it.
I never took a ride from him.