Hole in the Wall

Hole in the Wall is a side quest in Fallout 4.

Detailed walkthrough
After donating blood to Dr. Forsythe, leave the vault and either pursue the Here Kitty, Kitty quest to find Ashes or else wait for 24 hours or more before returning. (You may have to complete another quest in addition to waiting 24 hours before the next scene will trigger). Austin Engill will have been moved to the vault's medical bay. Speaking with Dr. Penske begins the quest.

Austin was bitten by a mole rat when wandering in a secret partition of Vault 81 and subsequently fell ill. The player must follow Bobby De Luca to the entrance hidden in the reactor room. They are asked to go into that part of the vault and find a cure. During the investigation, they must fight their way through run-down rooms full of Vault 81 lab mole rats, which will transmit a disease if they manage to bite the Sole Survivor, conferring a potentially permanent penalty of -10 hp. The true purpose of Vault 81 as an infectious disease incubation and vaccine development facility is also discovered. In the final area there is a terminal that must be hacked or unlocked with a password in the far room on the upper floor past a mole rat brood mother. password to the locked terminal is next to the research comm terminal in the subsequent room. After this the player finds a robot named Curie who has manufactured the cure; however, there is only one dose left. Curie follows the player out of the secret vault up an elevator back to the locked door by the main vault's entrance. The player must then return to Dr. Forsythe in the medical bay with the cure and make a choice:

Option 1: Give Austin the cure
If the player character gives the cure to Dr. Forsythe, they receive rewards including the syringer rifle and a room in Vault 81. Most items throughout the vault are no longer marked as owned and can be freely picked up without angering the residents. As a side effect, if the player character has contracted the disease during this quest, they keep the disease permanently (-10 max HP).

Option 2: Deny Austin the cure
No matter whether it's by directly refusing it in dialogue (requires selecting "Only one, it's mine" followed by "Let him die") selling or losing it, or using it on yourself (possibly to cure your own mole rat disease), all of these options are treated the same; Austin dies and everyone in Vault 81 blames the Sole Survivor. A small memorial for him is prepared in the classroom under the "America lives on ... in you" poster, consisting of a candle, a new teal flared vase, a toy car, a baseball glove and a teddy bear.

Either way, the quest concludes and Curie asks to accompany the Sole Survivor around the Commonwealth in order to further her scientific research, becoming available as a companion.

Companion affinity

 * Cait and MacCready dislike giving Austin the cure and like keeping it for yourself.
 * Danse likes giving Austin the cure and dislikes keeping it.
 * Codsworth, Preston, Piper, Hancock, and Nick love giving Austin the cure and hate keeping it.
 * Strong likes either outcome.
 * Virtually everyone dislikes the option to split the cure, "good" companions for being selfish and "evil" companions for offering even that much of it to Austin. Danse doesn't care, and Deacon likes this option, as well as loves giving Austin the full cure and dislikes keeping it.
 * There are no affinity changes for the second set of dialogue after keeping the cure for yourself, whether you back down and decide to give it to Austin after all, or stand by condemning Austin to death, so changes are reflected in the first choice only.

Bugs

 * The cure can be used on both the player character and Austin if, during the conversation with the doctor, the player tells him to use the cure on Austin then quickly backs away and uses the cure on themself before it is removed from the player's inventory. Note that you have to use the cure after Dr. Forsythe begins responding, otherwise you will trigger the dialog for having used it yourself. Using jet before talking to him helps you with this considerably.
 * If you leave the vault before Bobby opens the secret door, he will have gone into the secret vault with the secret door still being closed, making it impossible to finish the quest.
 * If leaving the hidden vault with the security key holotape in the inventory one will no longer be able to access the locked door to get the cure as the terminal which opens it will not register that the Sole Survivor has the holotape anymore. Sometimes this will happen even if one does not leave the vault, and progress will become impossible without cheating.
 * Dr. Penske will not be in the room discussing her grandson's illness with Dr. Forsythe and will not start the quest. One can go to Dr. Penske's office and talk to her there to start the quest.
 * If companions or other NPCs are bit by mole rats, they will "contract" the disease and add it to the player's list of active status effects as though the player was bitten.

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