That's a lot of stuff in regular use. I think my head would explode.
Well, I'm unusual in that I put almost everything I think about on the screen. The first 12 buttons on the bottom left are hotkeyed to my number keys, but beyond that I don't really have anything bound (which is fairly unusual). That said, the rows on the left are the ones I mainly use for raiding, the ones on the right are used for misc stuff (for a weapon swap, mounts, a few macros, first aid, professions, things like that)
That's awesome.
Using 2 swords and 1 spell in The Witcher is about my limit for realtime fantasy multitasking. ANything more and I'd just be drooling on myself.
Doing dps rotation is lot simpler than tanking or healing, I think.