I also play with the aerial view camera. I do however agree that the general's camera is more realistic and a tougher view to play well, especially in city sieges. Having tried the general's view a few times, I could never really get used to it though I did win most fights comfortably (mainly fought on plains).

As for the pause button, players don't have the benefit of being able to react simultaneously as the computer AI does when giving orders. There are also certain things that individual unit commanders should know of such as to avoid friendly fire which you would have to order on the spot.
I've heard of players using lots of hotkeys and groupings when playing without pause but it certainly sounds tough and would demand really good reflexes and camera control.