well not that cool, but a lot cooler.

I finished installing the beast and at first it didn't actually lower the peak temperature that I previously was able to reach with Furmark stress test. But at least it did take much longer to reach that same 93C that I achieved after the PC cleanout. Also since the heat sink compound was just newly applied, it might have needed to bed-in.
The next day, I installed a small pci slot exhaust fan which sits above (tower case) the vid card. This brought the peak temp down a few degrees. After that, I attached a 92mm thermistor-driven fan (Silenx) to the the beast cooler. After that (and rearranging some cables in the case a bit) I now hit a peak of around 65C with the Furmark stress test. almost 40C lower than when I started all this
One issue is that for a tower case, this one is not the best when it comes to cooling a hot card (like a video card). The design is great for cooling CPU and RAM, as there's a cowl that covers them like a tunnel, with fans at front and back of the case. The only other exhaust fan on the case comes from the PSU at the top. But in spite of all this and while still running with the Asus "Q-Fan" config under 'optimal', things are much better.
Anywhooo back to the game. I found almost no stutters in that same training mission. Had one bad one but I think that some of them are related to CPU load peaking for some reason, and not the video card's throughput. As Tessa mentioned, I think a move to Win 7 should make things smoother overall. This mobo/cpu combo still has some life in it; I have even overclocked the RAM a bit to nearly 4400MB/s (setting DDR2 888 + some CAS tweaks), although supposedly I can get it up to DDR2 1066 with the right Kingston RAM (according to Asus). I might upgrade the HDD to something with bigger cache like 32 or 64 MB.
Blah blah blah, but many thanks to everyone to chimed in, your support was very helpful. I can definitely recommend that anyone with choppy system response/performance should analyze their "thermal situation" to make sure it isn't a source of problems.
Ok, I think I'm ready to get back in the game