Walk into Jacobstown for the first time and you’ll see plenty of things that should, by all rights, kill you. It’s a mountain retreat packed with Nightkin—schizophrenic, blue-skinned Super Mutants who love nothing more than staying invisible until they’re close enough to cave your skull in with a bumper sword. But then you meet her. You meet Fallout New Vegas Lily, or Lily Bowen if you’re being formal, and suddenly the Mojave feels a little less lonely. She’s wearing a sun hat. She’s got a Vertibird blade strapped to her back. And she really, really wants to know if you’ve been eating your vegetables.
Lily isn't just another companion. She’s a 75-year-old grandmother from Vault 17 who got dipped in a vat of FEV (Forced Evolutionary Virus) by the Master’s army back in 2103. That’s a heavy backstory. Imagine being a peaceful gardener one day and a hulking, 800-pound mutant the next. Most games would make that her entire personality, but New Vegas writer Chris Avellone did something way more interesting. He made her heart-wrenching.
The Mental Health Struggle of a Nightkin
Nightkin are unique. Unlike your run-of-the-mill Super Mutant, these guys are addicted to Stealth Boys. Using those invisibility devices for decades has basically fried their brains, leading to severe paranoid schizophrenia. In the case of Fallout New Vegas Lily, this manifests as "Leo."
Leo is the voice in her head. He’s the personification of her combat rage, the part of her that remembers being a killing machine for the Master. When Lily gets down to half health in a fight, she loses it. She goes into a psychotic break, her "Grandma" persona vanishes, and Leo takes the wheel. It’s terrifying to watch, honestly. You see this sweet old lady suddenly screaming about blood and guts while she hammers a Centaur into the dirt.
But the real tragedy is why she stays this way. She has a holotape. It’s a recording of her grandkids from before she was mutated. It’s the only thing she has left of her humanity, but here’s the kicker: she can’t hear it clearly unless she refuses to take her medication.
The Choice No One Wants to Make
In her personal quest, "Lily and Leo," you have to decide how she handles her medicine. This isn't just some "Press X for Good Ending" choice. It’s messy.
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If you tell her to take her full dose, she becomes calm. Leo goes away. But there’s a cost. Her memory fades. She forgets she ever had grandkids. She becomes a shell of herself, peaceful but hollow, eventually wandering away because she doesn't know who she is anymore. It’s a mercy killing for the mind.
Tell her to stop taking it entirely? She becomes a monster. Leo takes over. She becomes a legend of terror in the wasteland, a beast that eventually forgets the "Lily" part ever existed.
The "middle" ground is keeping her on half-doses. She stays confused. She stays a bit crazy. But she remembers her family. Is that better? To live in a state of perpetual mental fog just to cling to a memory of people who have been dead for over a century? It’s one of the most ethically gray moments in the entire franchise.
Why Lily Bowen is the Best Tank in the Mojave
Let’s talk mechanics for a second because, at the end of the day, you’re probably bringing her along to keep Deathclaws off your back. Lily is a beast.
She has the highest health pool of almost any companion. Because she’s a Nightkin, she has a natural affinity for sneaking, which is hilarious given she’s the size of a small shed. Her perk, Stealth Girl, makes your Stealth Boys last twice as long and gives you a 10% critical hit damage bonus while you’re sneaking. If you’re playing a sniper build, she’s actually more useful than Boone in certain tight corridors because she can soak up the damage while you reposition.
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She uses a "Silenced" Mk2 Stealth Boy. It’s not actually silenced—she just thinks it is. That’s the kind of character writing that makes New Vegas stand out even in 2026.
- Primary Weapon: Vertibird Blade (it's literally a rotor blade turned into a sword).
- Secondary Weapon: Assault Carbine (she fires it one-handed like a toy).
- Special Ability: Enrages at 50% Health (Leo comes out to play).
Most players make the mistake of giving her a different melee weapon. Don't bother. Her Vertibird blade has a massive reach and high knockdown chance. Just give her some heavy armor—though she can’t wear most standard sets—and let her go to work.
The Vault 17 Connection
A lot of players breeze through the dialogue and miss the lore significance of her origins. Lily was 75 when she was taken from Vault 17. This wasn't some random kidnapping; it was a targeted raid by the Master's forces. Vault 17 was located in California, and its inhabitants were known for being "prime normals." This meant they had very little radiation damage to their DNA, making them perfect candidates for FEV dipping.
When you talk to her, she mentions her "little ones." She’s talking about children who would be long gone even if she hadn't been turned. It adds a layer of "Old World Blues" that fits the game's theme perfectly. She is a literal relic of a world that died twice—once in the fire, and once when she was dipped in the green goop.
Common Misconceptions About Recruiting Her
You can't just walk up to her and say "let's go." You need to head to Jacobstown, which is tucked away in the Northwest corner of the map. You’ll usually need to start the quest "Guess Who I Saw Today" by talking to Doctor Henry (the Enclave scientist from Fallout 2, for those keeping track).
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One thing people get wrong: you don't need a high Speech skill to get her on your team, but you do need it to navigate her ending without feeling like a total jerk. Also, if you kill the Nightkin in the cave during Henry’s quest, she won't necessarily hate you, but it sours the vibe of the town. Jacobstown is about healing, or at least trying to.
How to Maximize Her Effectiveness
If you want to keep Fallout New Vegas Lily around for the long haul, you have to manage her aggression. Since she enrages at low health, she has a habit of charging into groups of enemies and getting herself killed (if you’re on Hardcore mode).
- Keep her on passive until you're ready to engage. This prevents her from chasing a Bloatfly halfway across the map.
- Equip her with Oh, Baby! if you can find it. It’s a unique super sledge found in Charleston Cave. It turns her into a whirlwind of destruction.
- Don't use her with Rex. They don't have bad synergy, but their pathfinding in tight spaces like Vault 22 is a nightmare. You’ll get stuck in a doorway for ten minutes.
The Actionable Truth
To truly experience Lily’s story, you need to trigger her "Leo" barks. This happens when she takes significant damage or when you witness her having a psychotic break. Most players play too safely and never actually see the dialogue that leads to her quest progression.
Next Steps for Your Playthrough:
Travel to Jacobstown immediately after reaching New Vegas. Talk to Lily and ask about her "grandkids." Listen to the holotape in her inventory. Then, go find the stealth-mantis research in Charleston Cave. Pay close attention to how she reacts to the voices. Your final decision regarding her medicine will change her ending slides significantly, so think hard about whether you value her peace of mind or her memories more. There is no right answer, only the one you can live with.