Heh, you wimpy "I can't lift my left finger!" people are funny.
I find I have absolutely no problems making a right click. In fact in first I can't figure out HOW it knew I was right-clicking. I just thought, and did it instinctively, and it registered on the screen. That's it. After I did some experimentation, I did figure it out. It just works, trust me guys.
And what's this about finger lifting? It's not like you lift it and point it all the way up, then click. You just shift the weight to the right finger, and that makes your left finger lift a bit and I mean a BIT, you just have to lift enough to not TOUCH the mouse with your right finger, that's all. As for me it's no problem because I tend to rest my right finger on the wheel anyway, so I didn't even realize how it works at first.
The wheel, too small? Maybe, if you're trying to scroll the "normal" way. What I do, I just sort of "stroked" it. Like I'm stroking the mouse, but with the ball in the way. It's no problem once you get used to it. It's sweet, the ability to scroll anywhere - horizonal, vertical even diagonal. It's sweet.
As for gaming, I've not tried yet, but I'd imagine it would work just fine. No you can't click two buttons at the same time (since it's only one button), you can click right, center and left very quickly with no problem. It's not like you have to consciously lift your finger and act all dramatic "oohhh my finger hurts so much I can't stand the exercise! *grunt* *grunt*" and THEN click the right button...
My only complaint? The squeeze thing. It's... odd. It works much better than I thought, but it's still odd

I can get used to it fast, since it takes in the action of dragging a item, then exposeing to a window, then releasing and makes it very intuitive and nice. But for general purpose expose, it's odd.
And I'm just a little nitpicker, because I'm wondering... anyone who have the mouse notice the thingies on the sides are a bit off-center (not exactly flush with the rest of the body)? It's very slight, but I'm just a nitpicker like that.
Overall rating: "I'm selling my MX1000!" stars.