Blood Ties

 is a Fallout 3 quest. It is also an Xbox 360 and PC achievement, and a Playstation 3 trophy. It is the story of a man's struggle within his own mind and the consequences of that inner turmoil, directed onto his family.

Quest Start
Given by Lucy West in (or wandering outside) Moriarty's Saloon in Megaton. However, if you have already destroyed Megaton, it can also be started just by visiting Arefu and talking to Evan King.

Deliver Lucy's Message
Lucy West asks the player to deliver a letter to her family in Arefu. She will mark the location of Arefu on the your Pip-Boy 3000 if the player accepts the quest. If the quest was declined, you can find the location of Arefu here, on top of the highway overpass.

Report to Evan King
Evan King will toss a grenade at the player as you approach Arefu. He apologizes, explaining that the town is defending itself from a gang known as The Family. Evan will ask the player to check the Ewers, Schenzy, and West residences to make sure everyone is all right (this starts the quest for the player if he/she didn't pick it up from Lucy). The player discovers the bodies of Lucy's parents; further examination shows they have bite marks on their necks (requires 30 in Medicine skill). The higher your medicine skill the better your examination and with 75+ Medicine you can conclude that the teeth mark are from human teeth. When the player reports to Evan King he will ask about Lucy's brother, Ian West, who turns out to be missing. Evan presumes that he may have been kidnapped by The Family and asks you to locate them. At this point, the player can extort 100 caps out of Lucy West with the Scoundrel perk.

Locate The Family
Evan King now will reveal three possible locations of The Family when the Lone Wanderer tells him that Ian's body was not found with his parents; these are Northwest Seneca Station, Hamilton's Hideaway and Moonbeam Outdoor Cinema. If the Lone Wanderer has a high enough Medicine skill (90 or higher) he/she will notice trainyard residue on the bodies of the Wests and will be given the option to ask King if there are any trainyards nearby, he'll respond by mentioning the Meresti Trainyard.

The Family is hiding in Meresti Metro Station which can be reached via the tunnels under Meresti Trainyard or via the adjoining tunnels from Northwest Seneca Station, but the Meresti Trainyard offers the most direct route. Beware of mines and traps inside the tunnels.

Entering from Northwest Seneca Station:

Enter the station and you will find Murphy's chem lab operation. In the back of his office you'll find a hatch. This hatch leads down to the Meresti Service Tunnel. When inside the tunnel be cautious, there are various traps and two mirelurks there. After going through the cave you will enter the old train trail, then make a left at the first train wreck.

The front gate to The Family's hideout is guarded by Robert who will allow the player into The Family's home for one of the following:
 * 100 caps
 * Free with a successful Speech check
 * If the Lone Wanderer has Lucy's Letter for Ian
 * Speech options from the Cannibal perk which also opens up many speech options which make the quest much easier

There is a room to the right after entering the gate. A table is in the room that has a Tumblers Today book on it which doesn't cause you to lose karma to pick it up. Robert can be killed and the terminal in the room adjacent to his post can be hacked to gain entrance, but the rest of The Family will turn hostile towards the player. Sneaking past Robert and into the compound will also result in the rest of The Family turning hostile. Killing a member of The Family at this point in the quest will result in negative karma.

Locate Ian West
The next task is to locate Ian West to determine if he is still alive. Several members of The Family will reveal Ian's location and the password to unlock the room where he is meditating, following is a list of possible scenarios:
 * The leader of The Family is Vance - a mysterious and charismatic man who is trying to help the members of his "Family" overcome their disturbing hunger for human flesh by drinking human blood akin to the mystical vampires in the stories from before the Great War. If the player fails a Speech check, Vance will advise the player to learn the rules of The Family by asking other members and reading from the terminal in the main lobby. If the player passes the Speech check, uses the Cannibal perk, or reads the rules and explains he understands The Family then Vance will give the pass code that allows entry into Ian's meditation room.
 * Alan notices that Justin has been trying to befriend Ian and suggests the player talk to Justin about him.
 * Justin believes that Ian belongs with The Family having witnessed the murder of his parents and done nothing. If the player suggests that Ian needs an 'outside voice' to help and passes a Speech check Justin will reveal the pass code that allows entry into Ian's meditation room. The Impartial Mediation perk gives a similar dialogue option with an identical result (even if you do not have neutral Karma when you ask the question).
 * Karl will become annoyed if asked about Ian. Karl can be seduced by the player by using the Black Widow perk (female) or by Strength (both sexes). In either scenario, Karl gives up the pass code to Ian's meditation room.
 * Brianna also feels that being with The Family is the best for Ian but that he could use an outside friend. If the Lone Wanderer picked up the Lady Killer perk he will have the option to seduce Brianna into handing over the password to the room where Ian is. Scoundrel or Intelligence or even Speech will work as well.
 * Holly, Vance's wife, can be persuaded to reveal the pass code with a sufficiently high Charisma or with the Scoundrel perk.
 * Vance can simply be killed and the pass code looted from his remains. This will of course cause the rest of The Family to become hostile towards the player, attacking on sight. Each family member killed will result in negative karma at this point. Ian will be angry that Vance has been killed but will give the player the same ultimate options regardless, as long as you do not respond flippantly to his death. (responding with "Well, he's worm food now." results in Ian turning hostile towards you and failing the quest)
 * You may also goad Vance with certain conversation options, finally calling him a "psycho", and he will order the Family to attack - this will allow you to follow the above option but result in no negative karma from killing them. (Note: This path must be taken before Ian comes to any decision. See Bugs.)

Talking to Ian will confirm he was not kidnapped but voluntarily joined The Family after killing his parents. After a childhood encounter with a threatening Wastelander Ian has craved human flesh and blood, even that of his own mother and father. The player is then faced with the choice of convincing Ian to leave - which requires either the letter from his sister Lucy or passing a Speech check if Vance is still alive - or leaving him with The Family.

Settling Accounts
Ian's decision must be relayed to Evan King back in Arefu. Depending on which choice Ian made the appropriate parties will react with enthusiasm or disappointment. Reporting the news of Ian's decision to King will result in a sizable amount of good karma regardless of Ian's ultimate choice. After Ian's decision The Family and the residents of Arefu are considered to be the same faction even before the deal is made with Vance.

Vance may also be convinced to either not attack or to defend Arefu if he and the family are not already dead. If the player simply asks Vance to stop attacking Arefu, he will agree. Through a successful Speech, Medicine, or Intelligence check, the player can also convince Vance to enter into a deal to use blood packs instead of attacking the residents of Arefu. Regardless of the conversation choice, Vance will award the player with Schematics - Shishkebab, a flaming sword, after the initial conversation about the deal is over.

If the player brokered a deal they can return to Vance after the deal is relayed to King and ask to be shown the ways of the vampire. The player will then be taught to drink blood and awarded the Hematophage perk which modifies Blood Packs to heal 20 HP instead of 1 HP. If the player suggested the Family guard the town in exchange for blood Alan will be dispatched to Arefu, fulfilling their end of the deal.

After successfully dealing with the problem of Arefu each of its inhabitants will show their gratitude in the following ways:
 * Evan King will (periodically?) give Beer, Wine, Scotch, Vodka, or Whiskey to the player.
 * Ken Ewers will repair stuff (up to 47%) for a price.
 * Brailee Ewers will give her "old-fashioned chocolate chip cookies" (which is actually a Tin can) to the player.
 * Karen Schenzy will mark several locations on the player's Pip-Boy 3000.

Bugs

 * When you first approach Arefu, Evan King may run past you to attack an enemy if you led them there. If this happens, the explosion will still occur and you will be frozen in place as the game waits for the encounter to occur. You can either load a previous save from when not on the bridge and kill the monster following you, or wait for Evan King to come back which can take a while. Eventually he will walk past you and return to his usual position, in which the dialogue sequence will then initiate. The game may freeze. (Confirmed; Xbox 360 & PS3)
 * If The Family is inexplicably hostile, Vance may never appear in the game, making the quest impossible due to the lack of password for the terminal. (Confirmed Xbox 360)
 * If the player kills any member of The Family after Ian makes his decision the inhabitants of Arefu will turn hostile even though no one from the town was directly attacked or killed. This is due to the fact that Arefu and The Family become one faction after Ian makes his decision, rather than after the deal is struck between Evan and Vance. If the player attacked The Family instead of talking to them initially this can be a problem if Robert the gate guard is not killed before speaking with Ian. When the player leaves Robert will be hostile but if the player kills him the quest will be failed. If the player kills all residents of Arefu, the quest will also fail. (Confirmed, PS3, PC, and Xbox 360)
 * You can work-around this problem by simply getting past Robert, without killing him, in sneak mode. A stealth boy or the Chinese Stealth Armor may come in handy (although its possible without). Bear in mind that your followers and Dogmeat will attack Robert so be sure to tell them to wait far away as Robert will start a way point path after you stealth past him. (or send to the entrance of Vault 101 in Dogmeat's case)
 * If you already killed Robert or another family member, but you haven't yet received the message that you are hostile to this faction, you can restart this by repeatedly pressing the "wait-button". Doing this, you still can talk to Evan and finish the quest successfully. Waiting for 24 hours seems to work the best. (Confirmed, Xbox 360)
 * If you are in a situation where you would rather not fire and lose a companion you can tell your party members to wait you in the previous area. However after talking to Evan King (and completing the quest successfully) the player has to come back and regroup with their now-waiting followers. Killing Robert even then will result in violent reaction from Arefu residents and Lucy, making further contact with Arefu impossible. In short, you have to decide between loosing a companion (if you are using glitches to get more than one companion) or losing the goodwill of Arefu towards you.
 * If you haven't started the Blood Ties quest yet, and you go to Arefu during the time that the Enclave may randomly spawn in the area around, you may see them attacking Arefu. When this happens, if you kill the Enclave, they may or may not have already killed Evan King. This will result in Lucy West and Robert assuming you killed Evan, and Lucy will never give you the quest start, and you cannot ever start the quest. However, Robert will not question you, and you can pick the locked gate however this will turn The Family hostile towards you, but you lose no karma for killing them since they initiate combat.
 * While the Family's Terminals are not red when highlighted (it will be your regular HUD color, as if open-use), being seen hacking into them by any member of the Family will result in The Family turning hostile as soon as you exit. (Confirmed, Xbox 360)
 * Sometimes when you do this mission the option to ask Vance about Arefu does not appear, so save before talking to Ian.
 * While checking on the residents of Arefu, after you check on one, the door is locked. (Confirmed, Xbox 360)
 * Sometimes, after getting Ian West to return to Arefu, the residents of Arefu will turn hostile for no reason and the quest will fail. (Confirmed, on all platforms)
 * Rarely, you can start the quest normally from Lucy in Megaton, and talk to Vance, and when you go to give Lucy's Letter to her brother Ian - it will not leave your inventory.(PC - Collector's Edition)
 * When knocking on the doors of one of the two locked houses, you get stuck on the "..." message. ( saving is advised before checking the houses as well as checking the West residence as last)
 * If you sneak past Robert and The Family is hostile to you, it's possible for them to open the door to Ian's room while searching for you (after alerting them.) Talking to Ian afterwards will still require you to say Vance is dead. After this, the residents of Arefu are hostile to you, resulting in quest failure.
 * Theres a minor bug where a Yao Guai(or some other creature) may spawn in arefu while you are checking the families.If the creature kills Evan everyone in Arefu, including the Family will turn hostile to you.

Behind the scenes

 * "Vespertilio", the password to Ian's cell, is a genus of Vespertilionidae bats.
 * Alan informs the player about the "Meresti" name originating from that a town in Romania. He probably refers to the town of Mărăşti, famous for a decisive WWI battle.