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The Blood Ties quest is part of a larger quest that starts in Megaton. It will take you to the isolated town of Arefu and introduce to a very “unique" family. The quest itself isn't too rewarding or special. You'll get some schematics for the shiskabab and a new opportunity to make money, but that's about it.
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Wasteland Mail Service
This quest technically starts when you talk to Lucy West in Megaton. She'll ask you to run a letter through the wasteland to her brother in Arefu. This is a good way to start it, since it will mark the town on your map. You can also get the quest by walking to the top of the highway ramp into town and triggering your special welcome.
Regardless, you'll need to travel to the northwest of Megaton to find Arefu. It's a little settlement built up on the remains of a highway. Climb up the ramp until you're forced to stop to avoid a grenade. It seems that they're on high alert. Talk to Evan King to learn about their situation. It seems like some gang called The Family is harassing them. We'll need to help Evan out by taking a quick census.
Visit each of the 3 houses to check in with the residents. You obviously don't need to go into Evan's house, although it should have the repair bobblehead inside. You might want to pick the lock now. The first two houses by Evan are alright. The problem is the third house in back. Naturally it is Lucy's relatives who are pushing up mutated daises. Examine the bodies to make it official.
What happens afterward changes depending on your skills. You can make special note of various things on the bodies if you have the right skill. Most of it is just a hint at what you'll be facing. For example, you can notice that they've been drained of all their blood. The only relevant one is if you have Medicine higher than 70. If so, then you'll notice trainyard residue around their bodies. You can then ask Evan if there's a nearby trainyard, which will led you to Meresti Trainyard.
You can always just go to Meresti Station and head inside to their hideout, regardless of whether your character figures it out or not. It's not necessarily any faster to find the station blind than it is to just follow the clues though. Plus, we'll find another side quest if we do it the “right" way.
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Finding the Family
If you don't have Meresti marked on your map, then we'll have to stick with the vague hints. Hamilton's Hideaway is not just a bust, but a red herring. Don't bother exploring the bunker, since it should be empty. You need to go to Northwest Seneca Station. Don't worry, this isn't another station crawl. Go up to the station and inside. Approach the door at the end to stumble across a few ghouls. This is a separate quest. Be nice and he'll offer to pay for sugar bombs as part of his drug dealing.
Your real goal is past his office and in a room with some radioactive waste barrels. The waste is partially hiding a manhole. Quickly use it to access the service tunnels beneath the station. These tunnels are filled with mirelurk, but you should know how to deal with them by now. I ran into 2, but you might always find more. Just shoot them in the face when they rear up to attack you. Once you make it to the end of the tunnels, you should come out into a Meresti Station.
Stay very alert here. There are tons of traps in this tunnel leading up to The Family's hideout. I actually think that there's one of each type except for a grenade bundle. Turn on your flashlight and watch the floor for mines and bear traps. There are also a few tripwires rigged up to shotguns and pitching machines. You don't need to leave the tunnel itself though. You just need to get to the first intersection and then walk down the line of subway cars to get to the fortified entrance to the hideout. Robert, the gate guard, should stop you. You can either pass a speech check, show him the letter, or bribe him to get inside. If you kill him, then it will probably set the entire Family hostile to you. I'll also note that if you have the Cannibal perk, then you are basically a member and you can play that card for the whole quest as an instant pass.
Head on into their section of the subway.
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The layout is pretty simple. The downstairs area holds the shop, the general terminal, and it serves as a hangout for most of the members. The upstairs holds the beds. Vance's room is upstairs and to the side. Ian is also just past the turnstiles inside a locked room.
There's a lot of ways to do this one. Kill 'em all is an acceptable path. You just need to gun down 5 lightly armed guys and Vance. It's not too rewarding though and it gives you bad karma if you don't taunt Vance into attacking. You can then just rescue Ian with the code from Vance's body. You should try to stick it out and do it right though. You can get the code for Ian's room by passing a speech check with his new friend Justin or by passing a Strength test while threating Karl, the shopkeeper. You can also sweet talk Brianna or Holly. It doesn't really matter though. The best way to do it is to go up and talk to Vance. Be nice and listen to his story. You can guess that he's basically forming a vampire coven, but if your speech or intelligence isn't high enough you'll need to do one extra step.
He'll give you the password to their common terminal downstairs. Go down and access it to learn that the Arefu incident wasn't authorized and that Vance is basically trying to save a bunch of cannibals by making them into vampires. Go back up and tell him that. You might need to end the conversation and restart it, but you should have the option to say that you understand The Family and want to talk to Ian. He'll then give you his permission. You could go in by just getting the password, but he doesn't really appreciate you not listening to him.
Use the terminal by Ian's room to unlock the door. Then go inside and talk to him. Be nice and offer him Lucy's letter. It will help sort him out and convince him to go home. You can also use general conversation to either get him to go home or just stay there. It honestly has no real effect on anything.
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With Ian's decision finalized, you need to talk to Vance again. You might want to save first, since you can also determine the fate of Arefu. By just talking to him, you should be able to get him to promise to call off the hunt. If you have a bit of Medicine or Intelligence, then you can ask about other sources of blood. He'll mention blood packs being viable. You can then convince him to trade either money or protection to Arefu for blood donations from the citizens.
He'll then hand you an offer to take to Evan. Go back out and into the tunnels. Just pop out into the Meresti Trainyard and fast travel back to Arefu. Hand the proposal to Evan to get him to sign it and agree. Then head back to Vance to cement your agreement.
Ian will settle in at either place. Lucy won't have much to say either way. The townspeople of Arefu will give you a bottle of whiskey, a tin can, and a few new markers on your map if you do the rounds after saving them. Evan will occasionaly have more alcohol to give you, but it's a bit of a trip for some booze.
Vance and the family will continue to do business in their section of the subway. You should be able to sell blood packs you find to Vance for a tidy profit, if you're willing to make the trip. Vance will also give you the schematics for the shishkebab. Finally, you should be able to pick up the Hematophage perk as a reward for negotiating a deal, if you ask Vance to instruct you in their ways. This will let you get 20 HP back by drinking a blood pack. It's not useful, but you might need it in a pinch. We're done.
*One important note is that Arefu and The Family form one faction after Ian makes his decision. Killing the Family will make Arefu hostile to you and vice versa.
Fallout 3 Quest Walkthroughs
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- Fallout 3 Walkthrough - Blood Ties
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