Blood Ties

 is a Fallout 3 quest. It is also an Xbox 360 and PC achievement. It is the story of a man's struggle within his own mind and the consequences of that inner turmoil on his Family.

Optional: Deliver Lucy's message
Lucy West can be found in Moriarty's Saloon in Megaton, or wandering around outside. She asks the player to deliver the letter even though she doesn't have any bottlecaps with her. She will mark the location of Arefu on the player's Pip-Boy 3000 if you accept the quest. Alternatively the quest can be declined if one is aiming for the bad karma path, if you do you can find the location of Arefu here.

Report to Evan King
Evan King will toss a grenade at the player at their approach to 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 alright, 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 Medicine skill), and Lucy's brother Ian West is missing.

Locate The Family
Evan King will reveal three possible locations of The Family when the Vault 101 Dweller 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 Vault 101 Dweller has a high enough Medicine skill (at least 90) 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 be reached via the tunnels under Meresti Trainyard or via the adjoining tunnels from Northwest Seneca Station, but the train yard offers the most direct route. Beware of mines and traps inside the tunnels, and two Mirelurks if you take the Northwest Seneca Station route. The front gate to The Family's hideout is guarded by Robert who will allow the player into The Family's home for 100 caps, or for free if the player passes a Speech check or has the Cannibal perk or kills Robert and hacks the (level difficulty?) terminal the room adjacent to his post.

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 read 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 they understand The Family then Vance will surrender 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.
 * Karl will become annoyed if asked about Ian. The Vault 101 Dweller can seduce Karl using her black widow perk if she has it or intimidating him if his/her Strength is high enough.  Karl will then reveal the pass code that allows entry into 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 Vault 101 Dweller 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.
 * Holly is Vance's wife and refuses to override his orders believing Vance will help Ian and that Ian was rescued by The Family. However, if you have a high enough Charisma, you can convince her to give you the password.

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 mother and father. The player is then faced with the choice of convincing Ian to leave, which requires the letter from his sister Lucy or passing a Speech check, or leaving him with The Family.

Alternative: Vance can be killed and the pass code can be looted from his remains, as well as a Schematics - Shishkebab and Vance's Longcoat Outfit. This will cause the rest of the Family to attack the player including the gate guard, Robert. Ian will be angry that Vance has been killed but will give the player the same ultimate options regardless. See Bug section for a bug related to this method.

Settling Accounts
Ian's decision must be relayed to Vance and 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 leave either not attack or defend Arefu if he and the family are not already dead. If the player simply asks Vance to stop attacking Vance will agree. The player can also convince Vance to enter into a deal with the town and use blood packs instead of attacking the town with a Speech check, a Medicine skill check, or an Intelligence check. 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 asked 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 restore 20 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.

Bug
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. 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 goes to exit Robert will be hostile but if the player kills him the quest will be failed.