I'd do things like hand-roll my own XML parser in PHP (never mind LibXML bindings, etc) while trying to make sure I was observing the Visitor and Command patterns, oblivious to the silliness of the situation.
I also missed the understanding of dependency injection (or just management in general) that would have made that hellishly large Flash project so much easier to test and assemble.
Somehow I still managed to get a lot done. I feel in retrospect, that the Design Patterns are good to know about, but I don't know about whether anyone should intend to implement them.
Unfortunately, people do often attempt to start from the pattern, which gives the whole idea of patterns a bad name, since most people's primary exposure to them comes from Some Guy In The Office Who Just Read The Gang Of Four Book And Now Tries To Use Patterns For Everything He Does. And everyone, rightly, hates working with that guy or his code. The same thing happens with XP/Agile/TDD, where most people's exposure to them is from some annoying zealot rather than someone a little more experienced and pragmatic.
Actually, I wish I had done so. Then, after dumping it in disgust, I wouldn't have allowed programming to burn my youth, and would perhaps now be in an honest and not yet intellectually-stunted field like chemistry - where cube farms are unknown and the subject has some actual (vs. accidental) depth (see: http://tinyurl.com/lfzb58)