I guess that polar projections really give you fits. Transverse Mercator projection might be nightmare inducing event if you ever saw one. McArthur's Universal Corrective Map of the World would probably cause your brain to seize.
I think you are too caught up in the orientation of the map. If we ever have a magnetic flip in our lifetime your whole world would be turned upside-down.
A map is just a compact means of communicating spatial relationships. Different orientations serve different purposes.
For example:
"The New York City Department of Transportation places pedestrian friendly maps around the city with the orientation rotated to be “heads-up” or forward-facing so that viewers are facing the map in the same direction they standing for readability. This helps pedestrians to better orient themselves in relationship to the landmarks on the map and to better navigate the city." from geolounge.com
For D&D, most maps have to fit on a standard sheet of paper and a North orientation toward the narrow edge doesn't work for many situations.
However, where orientation really matters is in computer games. It does bug me when an interior cell has a different orientation than the exterior cell. So if I enter a building from a west door, but in the interior the door is now on the "north", well that is irritating. It just means the person that designed the space wasn't paying attention to the details.