I've always lived in the city and loved the noise and bustle but having lived in the country for 3 years now I loathe the occasions I have to go there. I thought perhaps it was an age thing.
I lived in Palermo for 6 months about 10 years ago and it's surely the noisiest place I've ever been. Double and triple parking is the norm and the procedure when you find your vehicle blocked in is to lean on the car horn until the owner of the offending vehicle emerges from one of the surrounding buildings. I've never seen anything like it. But apart from that, and the filth of the place, it's absolutely wonderful and the street food is to die for. Make sure you try the Piadina and the Panella.
Savagery. It seems for some people the horn is a universal method of expressing any and every emotion. We're headed toward Syracuse, so the opposite end of the island, but can't wait, both for sights and food :D