The only reason the desk is so clean is because of the picture. I just got everything setup Friday, normally it is pretty messy. However, I typically try to make a point of cleaning up at the end of each week. I try to enter everything that is still on note pads or sticky notes into Things and scan anything in that doesn't need to be on paper. I have things and my unfiled scans folder synced up with my home computer and laptop so it allows me to organize it all over the weekend from home (or wherever I am) when I have some free time.
What do I do? I develop web applications for use internally, manage my company's (not my, just work for them) ERP, and manage basically every piece of tech and software involved in all of our operations.
I always have virtual machines for XP (ERP, SQL Management Studio, etc.) and Server 2003 (development SQL server mainly) up and occasionally open up a Linux or Vista (and more recently 7) VM for testing.
The funny things about it is that having three triple monitors isn't that costly. I got a great deal on the monitor arms (because my company sells them) and the monitors are only $300/each. I'm not saying that $300 isn't a lot, just saying that $300 for an extra monitor that will last 3+ years isn't bad at all considering the productivity boost it gives me. An extra video card for the mac pro was $150 from apple (if you went somewhere else it would probably be cheaper). So all said and done it was $1050 for the monitors and card and then the cost of the arms (which aren't that bad assuming you buy online at places other than best buy, $30 for cheap ones or $50-$60 for decent ones). When you consider the cost of the mac pro being $4k, a little over $1k for the monitors is a no brainer. That being said I don't do photography or anything with video so color doesn't matter to me, as long as the syntax coloring looks good all is well for me. If you needed monitors with accurate color then the cost would be significantly higher. I do think the panel on my last iMac was a lot better than the dell monitors, but I wasn't about to spend $900 x 3 for cinema displays. I can see spending that for one but without needing high quality panels (or three webcams, three set of speakers, and three USB hubs) I can't justify that.