For google searchers and vogon members alike, here is my experience with Carmageddon/dgVoodoo/VDMSound. First off, I am extremely grateful to everyone involved in the various components that make it possible to play one of my (still) favorite games.

Carmageddon Max Pack (2 cd) with the included 3dfx support
dgVoodoo 1.40 plus
VDMSound

My system is an AMD64 3000+ slightly overclocked on a Lanparty NF4 UT motherboard (Highly recommended BTW), and an ATI X800 overclocked out of the box by Gigabyte. XP Pro.

Carmageddon will not run in "normal graphics" mode. I mean, it runs, and you can hear the menu sounds, but you get no video. So that option is out. So I skipped straight to "let's run it with the wrapper".

The wrapper without VDMSound has two modes. With the sound disabled, it runs WAY too fast. With my builtin sound card, it starts to work, then slows down a lot. But... with VDMSound, it's just right.

I have only played a few levels at this point. I have experienced one crash between levels, so I highly recommend saving your game after each level (since they can take an hour or so to complete if you're having fun). Also, the "damage gallery" after the race seems very broken. Otherwise, the game looks great.