LOL. I absolutely hate icons. I know people who's whole screen is covered with them randomly. I wouldn't consider myself a serial killer..I've only killed...3 or 4 people over the years.
Sometimes icons accumulate on my machines, but nce they get past 1 column I purge them down. Between the start menu and quick launch I find it easy to keep frequently used programs ready (I have 21 of them on my laptop), and the search has always worked really well for me in win7. Steam takes care of keeping the games tidy.
I have noticed people that have the random icon messy desktops seem to never use keyboard shortcuts either. Not that there is a wrong and right way to use a computer if your method works, but I could not imagine using a computer without keyboard shortcuts.