When I first played the game, I didn't know there was a translation patch and instead was using a guide to get me through any part where inability to read what was being said made me totally stuck. Even without dialogue the characters in this game are sufficiently emotive that I got a very good story, just... not quite the right story. For one, I assumed that King was a minion of the Doctor who eventually was inspired (either by the hero or by the doctor's actions) to switch sides in time for Sand Zone, because he had that mean looking scar and the first time you see him he's threatening a little girl (and the next major action he performs is imprisoning Sue). I assumed Sue was both a boy and a longtime friend of the main character who had come here (wherever "here" was) with him and in the end left with him to continue on their journeys. Certainly lent more weight to the part where Misery uses her as a hostage. I obviously didn't get any of the stuff about red flowers or floating islands, but that was ok because there was still a story without them. Most of the dramatic moments, especially Curly's death, carried through quite well.
Then I played through a second time, with the translation patch and saving Curly (and getting the spur). The real plot was, of course, equally good, but I almost feel kind of sad that I can no longer ever fully recall or relive the original experience of playing the game without knowing anything but what was shown through action. Then, of course, I did it several more times with self imposed challenges, because it was a good game.