Ergonomics are “old style”, which is to say there are some good points, and some not so good.
Feel and heft
This is a relatively large and heavy lens, comparable to the Nikon 70-200mm f/2.8G VR II, but somewhat more compact, and significantly lighter. The size and weight make it mandatory to support the lens on a tripod with the lens tripod foot— do not stress the lens mount by making the camera support it.
With a maximum aperture of f/4, the 200/4D is larger than it would need to be as a regular lens presumably because the ability to focus to 1:1 demands more extension; this is not a lens that appears to play tricks with focal length shortening as do most macro lenses these days. That is a big plus, because it means that working distance is excellent.
The lens is comfortable with a larger camera like the Nikon D3x/D3s, but will feel front heavy with smaller DSLRs. Supporting the lens is a very good idea; do not let it dangle and thus stress the lens mount.
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