You may not miss out on the locations or the storyline, but your choice of NPCs does influence, to a certain degree, what quests you take and how much fun travelling is...
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The last arrow of Legolas kindled in the air as it flew,
and plunged burning into the heart of a great wolf-chieftain.
All the others fled. -J.R.R. Tolkien, The Lord of the Rings
My thoughts are with America