...hygiene really is important!
It took me hours the other day to catch a bug that came from an unintended variable capture in a macro I'd written.
In a reduction semantics I'm implementing with PLT Redex, I wrote a macro to abstract over certain common patterns in my reduction rules. The macro template introduced a temporary name via a call to the name macro in PLT Redex. I thought name was implemented with a Scheme binding and would therefore be hygienically renamed. This was my mistaken assumption; name is implemented with a quoted symbol.
Then later in a reduction rule, I was using my macro and by chance introducing another variable at the call site with the same name as the temporary variable in the macro definition. This silently caused a capture of the quoted name, with unexpected consequences on the meaning of the reduction rule. In this particular case, it cause the reduction rule not to match when it should.
It took hours to discover that it wasn't a bug in my reduction rule at all, but in the implementation of my macro. Imagine trying to debug this if I hadn't just spent years studying macros and hygiene!