I define my campaign through art - specifically, through the use of initiative cards. I have each player provide me with a picture of what their PC looks like and print it off the size and shape of a standard playing card. This gets glued onto an index card and cut out, with the PC's name written on the back. Then the whole thing gets covered in Con*Tact paper and cut out again, this time leaving around a 1/8" border.
I do the same thing with every (major) NPC and monster the PCs meet up with. This allows me to stylize the monsters as I see fit. I play 3.5 and have always hated the "redesign" of the carrion crawler that started with the 3.0 Monster Manual, so by choosing a more accurate (for my campaign preferences) illustration for my "carrion crawler" initiative card I can easily show the players what a carrion crawler looks like in my campaign world when they meet up with one. This has also allowed me to sneak monsters past my players; when one teenaged player bought a Monster Manual and started reading up on the various monsters' weaknesses, I made sure to start using images that weren't the ones from his Monster Manual and occasionally referring to them by different names. So when they met up with a "fishman," he had no idea they were actually facing a skum and there were likely aboleths in the vicinity.
On the occasions where there isn't an image for the monster I want to build an initiative card for, I can either find something similar and manipulate it in the Paint program or simply draw it myself the way I want it to look.
As far as usage, the initiative cards not only allow me to show the players what their PCs are seeing, but they get used to track initiative (hence the name). Once everyone's initiative order had been determined (jotted down on scratch paper), I assemble the initiative cards of the creatures in question into a deck, with the top card showing whose turn it is. When that PC/NPC/monster completes its actions, the card goes to the bottom of the deck. If you wish to ready an action, your card gets placed sideways and put on the bottom of the deck; once you take that readied action, the card goes back to normal orientation. Once a creature gets killed (or all of that creature if there are multiple, say, skeletons in a fight), the card is removed from the deck. And if your PC does something like turn invisible, flipping the initiative card over backwards (name side up) is a handy reminder.
And to sound off on the "donkey eared elves" discussion, I'm definitely not a fan. I have used an image of a World of Warcraft elf for an NPC's initiative card, but only after I had manipulated it in the Paint program, snipping off his ridiculously long eyebrows and trimming his ears back to a normal length.
Johnathan