The amusing part is that I don't remember what the patch actually does. I mean, it replaces a bunch of opcodes with NOP, but I have no idea what. I vaguely recall spending a day in IDA Pro to find those bytes, but nothing about the details.
The really amusing part is that game developers haven't figured out what the problem is, either, and so my who-knows-what-it-does patch is a semi-officially blessed solution for now:
https://steamcommunity.com/app/61500/discussions/0/215439774...
Works like charm.
From what I understand, Microsoft could have totally kept 16bit application compatibility in 64bit Windows, but didn't for some reason. Apparently someone out there even compiled a version of NTVDM that works on Win 10 64-bit using leaked code or something.