I was really hoping that would not be necessary, as, due to my work in photo and video editing, I have a very convoluted install with lots of interdependent programs that I might use once every few years (and thus have forgotten how to set up properly) but, when needed, are absolutely vital. The chances of a clean install messing up my work in the future in hard-to-recover-from ways are high; unfortunately, it doesn't seem as if there's any way to avoid this now.
Nonetheless, one of my concerns is that this was caused by a consistent crash while attempting to install KB50003637, a problem that persisted even after doing a repair install. At this point, I'm not sure whether this was due to something about my installed system (a driver issue or something) or whether it might be an actual hardware problem requiring me to do a full system rebuild (which is close to being due in the first place).
The problem is that, while I agree that the reinstall should be done slowly and gradually, there are certain programs (mainly financial/accounting) I need to use every day, or at least every few days. Were I to do a clean install, I would need to be able to install and use those programs immediately. If it turns out that I do a clean install and find it is a hardware problem, having to then shut my operations down until I could order and receive parts to build a new system would be a complete non-starter. If that were the case, I would prefer to be keeping my machine in its current state, where most things outside of audio are functional, until I had the components on hand to rebuild everything.
My thought for how I could best approach this would be to temporarily pull the boot drive, replace it with a spare HD I have sitting around, and doing a clean install to that drive, including the problematic update. If everything in the bare install works well, I'll know it isn't a hardware problem and can replace the boot drive and proceed with the clean install "for real." On the other hand, if trying this technique results in more crashes with KB50003637 or some other update, then I'll have reason to suspect it's a fundamental hardware issue, and will be able to disconnect that "test" HD, reconnect my current boot drive, and be able to continue working in its current reduced-capacity condition until I have the parts in hand to do a new build.
Is there any reason why I should fear that this approach would not work, or would cause problems even after doing a clean install to my current boot drive (assuming the test install worked)? I can't see why it would, myself, but a friend who works in tech support at Microsoft suggested it could cause problems, and I thought I should run it by you before trying anything.