It should be noted that while this post was written Feb 2011, the patch (currently v 4.1 has been updated October 2011 .
I've tried it with three different computers and the GOG Fallout package, and in every case, Ian does not appear in Shady Sands. This rather restricts the opening game unless a character editor is used to increase Armour Class or otherwise counter Ian's absence.
It might also be noted that the patch also makes monsters' reactions more 'realistic' which rules out the 88-day option and getting Katja as first companion.
FIXT Alpha 3 does work with the GOG release, happily, it can be found here: http://www.gamefront.com/files/user/Sduibek
If anyone can get Alpha 4.1, the GOG Fallout release, and Ian all cooperating, please post how you did it!