They'd probably make the brotherhood of steel fight the aliens from mothership zeta or something. Gameplay wise, I've always been fond of the elder scrolls sort of action, but god dammit, I just can not stand how they messed up every single tiny detail from the original fallout games. Even bottlecaps for gods' sakes. Bottlecaps! I really doubt traders from the Hub would bother traversing coast to coast to trade with some dirty megaton mongrel or the slack jawed gung ho yellow skin muties that plague the Capital wasteland.
Ever since 2006, bethesda has been just terrible, and I blame Todd Howard completely. All we can expect from the next Fallout game will boil down to the Star wars prequels of the gaming industry.
Oh, and on a side note, is anyone tired of hearing the formulaic phrase: "I used to be a _________ like you, but then i took an arrow to the knee." Because I am!