Bellevue

Background
Bellevue is a dystopian city-state with a military dictatorship disguised as a humanitarian effort. The old Bellevue Hospital contains several Auto-Docs and Sympto-Matic units, that were all conveniently donated by Vault-Tec before the war.

However, like everything that comes from Vault-Tec, this was a joint ploy by the hospital and Vault-Tec. The hospital was struggling to make ends meet, as the costs of the city continued to rise. Vault-Tec donated the Auto-Doc with the joint understanding that it would ‘find’ some issue in every patient; an issue that would require monitoring and frequent doctor visits, at which point the Auto-Doc would administer a placebo to “keep it in check”.

This started only 3 months before the war, but by October of 2077, the Hospital saw a 1450% increase in return visits, and a 2025% increase in revenue, as the hospital gained an increase in new patients, after it gained a reputation for finding and treating more diseases more frequently than other hospitals.

Vault-Tec also benefited, by gaining a steady stream of patient files, allowing Vault-Tec to follow the health patterns of thousands of New Yorkers, as well as to study the effects of placebos and suggestions.

In the post-apocalypse, the Sympto-Matics continue their duty, creating records of every person to use the Auto-Doc, diagnose them with a disease, and continue to ‘treat’ them for about 50 years after the bombs fell, but had no stream of patients for over 100 years after the survivors died off. That was, until a family held up inside in 2240’s

At that point the Trophin family (see below) made their way inside the condemned building, and fortified it as a family settlement. Soon, the family’s children discovered the secret of the hospital’s past.

After discovering the ruse, the Trophin family continued to fortify the hospital, and began to monopolize the ‘service’ for travelers.

Soon, people came from all over to see the “Health Capitol of Manhattan”, and fell victim to the scheme. Many patients felt that they couldn’t go home, as the trips back and forth were too far or too dangerous, they couldn’t be without medicine, or other medical/logistic reasons. This created a dense town around the hospital, and as the demand for living space increased, the family extorted these people for even more money.

Eventually a city-state was formed, under the control of this family. They banned drugs and firearms, claiming it ‘harmed the health of the patients’, but in reality it was because those things just cut into their bottom dollar, and hired a mercenary band to act as guards. These guards are equally corrupt and often perform raids on homes and businesses, in the guise of searching for substances, but they usually will instead take bribes, protection money, or loot from the families and businesses they search.

Inter-City Relations
Bellevue boasts a unique status amongst the broken city-states of Manhattan, in that no individual state dares attack. This is less to do with the armed mercenaries, and more to do with the fact that many of the raider bosses have been convinced that they, too, have been diagnosed with a treatable, yet incurable disease or other health problem, and that only the Bellevue Auto-Doc can help them. The Trophin family has made it clear they will wipe the Auto-Doc’s programming if any attack is made; if they can’t have it, then no one can. As such, a sort of stalemate has been reached.

Auto-Doc & Sympto-Matic
The medical Machinery can end in many ways, but the majority of the ways will result in the loss of function. Following a loss of function, Bellevue will eventually collapse. There are a few ways to keep the Auto-Doc running (other than ignoring it)

Option 1: Ignore it
Ignoring the Auto-Doc will have Bellevue continue its status quo. It remains a military dictatorship decades later. The citizens are mostly none-the-wiser.

Option 2: Destroy the Auto-Doc
Destroying the Auto-Doc will cause the citizens of Bellevue to leave, as there will be no reason to stay. As everyone leaves each other, no one notices the trend of no one continuing to be sick; many attribute it as a miracle to themselves (not realizing everyone else is healed) or continue to believe they are sick and begin to abuse drugs in an attempt to self-medicate.

Option 3: Shut down the Auto-Doc
Shutting down the Auto-Doc will have many of the citizens stay in Bellevue in hopes that it will work again, but most will realize none of them are sick when they continue to live together well after it shuts down.

Option 4: Reset the Auto-Doc (Failed Fix)
Resetting the Auto-Doc will delete all the records of the patients in Bellevue. Since the medical conditions were assigned at random, after they return, they will be assigned a new, random disease. This will result in people becoming confused, and not trusting the Auto-Docs. The Trophins will not be accused of foul-play, but the citizens will slowly leave Bellevue out of fear of misdiagnosis.

Option 5: Fix the Auto-Doc (Successful Fix)
The fixed Auto-Doc will accurately treat/diagnose problems. This will lead to the revelation of the Trophin family’s deceit, and they will be deposed by the citizens, backed by the mercenary guards who feign ignorance. Since 90 percent of the citizens do not have chronic issues that require constant medication, they will slowly leave, but Bellevue will continue as a military city-state run by the mercenary group.

Option 6: “Improve” the Auto-Doc [Science/Perks]
You can “improve” the Auto-Doc to be fixed. This convinces the citizens that they are cured, the Trophin family stays in power, but the citizens do not need to stay after being cured. However, the massive influx of new patients waiting to be cured of their diseases keeps the Trophin family happy.

Option 7: Vault-Tec Abort Sequence [Item]
If you fail to meet the science/perk requirements for improvements, you can alternatively use the Vault-Tec Abort Sequence, which removes the Vault-Tec subroutines. This will have the same effect as Option 6, but the VTAS is a one-time-use item, and you will not be able to use it at Liberty Island, Heniton Tower, or Vault 64.

Option 8: Kill the Trophin Family
The most complicated and difficult path includes having the Trophin family ‘prove’ that the Auto-Docs are harmless by testing it in front of members of the town. You can program the Auto-Docs to kill the family. This will remove the Trophin Family, and cause the citizens to leave.

Mercenaries
By the result of your interactions with the Auto-Doc, the Bellevue Mercenary Group has 3 endings:

Ending 1:
As the city dwindles, the Trophin family can no longer pay the Mercenaries. They loot the city before disbanding, and returning to where they came from.

Ending 2:
The city continues to prosper under the Trophin family, and the BMG live a life of luxury and vice in the city.

Ending 3:
The Trophin family ruined, the Mercenary group takes control, and continues to run the city as a military dictatorship, but this time they are in control.

The Trophin Family
By the result of your interactions with the Auto-Doc, the Trophin family can have one of 4 endings:

Ending 1:
As their citizens abandon them, and they are no longer able to pay their mercenaries, the Trophin family fades to obscurity. Legends say they went South to the DC ruins. Some say they joined the Church of St. Monica to atone for their sins, but some say they were killed quickly by super mutants.

Ending 2:
The city, continuing as normal, the Trophin family remains in power for decades. The psychological dependence on them from their citizens is the perfect tactic for a dystopian regime like theirs.

Ending 3:
As their citizens turn on them, the Trophin Family fled East in the night. Many tried to follow suit, as a sort of vigilante mob, but the trail went cold somewhere in Queens. Last record, the family was seen in Woodside, but the legend says they made it all the way to the old Airport before being killed and eaten by Super Mutants.

Ending 4:
The Trophin family dies, under “mysterious circumstances” but no one is charged with their deaths.

Relation to Main Games
The pre-war success of the Auto-Doc in the Bellevue Hospital led to Vault-Tec’s installation of Auto-Docs in Vaults 8 and 34.