I’ve been using ThinkPads since 2005. I’ve always disabled the touchpad and only used the TrackPoint or an external mouse. A few years ago I’ve had some discomfort in my wrists, then I’ve stopped using the mouse entirely, and the discomfort went away soon. I haven’t used my mouse since, and haven’t had wrist discomfort either. I think one of huge benefits a TrackPoint has over touchpads or external mice is that you barely have to shift hand position when switching between typing and pointing.
At work, I’ve been using a PC with a Lenovo external USB keyboard, which is a 6-row keyboard with a TrackPoint, for a couple of years. I didn’t felt a big issue with the island style keys, although I still have a preference for the classic style keys. I did often miss the 7th row of keys, especially the Home/End/PgUp/PgDn. It’s just not the same with 6 rows.
Even though I was able to be quite productive with this keyboard, every time that I switched from the work PC to my personal laptop, I felt bliss due to how the keyboard feels.
Later at work, I switched to a 2015 MacBook Pro (and later to a 2020 one). I felt the keys feel a bit worse than the Lenovo keyboards, but they are good enough. It takes a while to get used to the different keyboard shortcuts, but I got used to most of them. After 3 years I still find it annoying not to have dedicated Home/End/PgUp/PgDn keys. I got used to the TouchPad rather quickly, and am using it exclusively. I learned to be productive with this keyboard and TouchPad, but once again, I feel much nicer when I go back to my personal laptop.
To summarize, I have regularly worked with 7-row and 6-row ThinkPad keyboards using TrackPoint exclusively, as well as with a 6-row MBP keyboard using TouchPad. I can live with and be productive with either of the three options (in decreasing order of preference, as mentioned), however if I could choose, I would choose the 7-row ThinkPad keyboard. And for my personal laptop purchase decision, this is one of the most important considerations. This is why all of my personal laptops are older ThinkPads: W530, X230, 2x X230t in my workshop, and an X220. All the *30 ThinkPads are modded with the *20 7-row keyboards installed.
I would buy a Framework laptop if/when a TrackPoint keyboard becomes available. Ideally, there should be no TrackPad at all, and the keyboard should be a 7-row layout like in the so-called classic keyboard from the *20 series ThinkPads. The TrackPoint buttons below the spacer are very important, especially the middle-button scrolling, as implemented on ThinkPads, it is a feature I use all the time. By the way, on the *20 series ThinkPads these buttons have a nice curve on it, which is missing on the *30 series.