National Catastrophe Relief Auxiliary - Response Unit MD - 478 The National Catastrophe Relief Auxiliary - Response Unit MD - 478 was a disaster relief response unit of the National Catastrophe Relief Auxiliary tasked with the evacuation and medical treatment of civilians from the Washington area just prior to the war . Background . Pre - War . All National Catastrophe Relief Auxiliary units was mobilized in the early evening of October 22nd . National Catastrophe Relief Auxiliary - Response Unit MD - 478 and other response units were deployed throughout the Greater Washington area and placed on alert in the event of a catastrophe . The cause of the mobilization was classified and even the Presiding Officers of each response unit was kept in the dark . Rumours originating from the Department of Defense spread through unofficial sources and Nancy Kroydon had it on good authority that the United States was under imminent threat of Chinese attack . She decided not to share her knowledge with the rest of her staff , fearing that they might desert to protect their families or spread panic among the general population . As of her first log entry , Nancy Kroydon noted how the unit had not been debriefed , another indication that something major was happening . On October 23rd , the Great War erupted and Washington , D . C . was hit by several nuclear bombs . Because of Response Unit MD - 478 ' s poor performance in the last round of drills , the unit was assigned to rural areas outside of Washington , D . C . , while higher scoring units were assigned to urban areas . Ironically this saved the unit from being immediately wiped out by the initial nuclear blasts . The response unit now began to oversee the evacuation of civilians and the medical treatment of injured and radiation poison victims at the evacuation center set up next to Germantown police HQ . Post - War . Almost immediately following the nuclear exchange , Response Unit MD - 478 became overwhelmed by the number of injured and sick . Looting also became increasingly widespread and scuffles at the evacuation center had also taken place . Nancy Kroydon was therefore relieved when a National Guard unit arrived from Pennsylvania after an all night journey . Despite the arrival of the National Guard unit , the situation continuously deteriorated and Response Unit MD - 478 suffered a severe lack of supplies . Even worse , two members of the unit , Rebecca and Dolores , deserted and headed for a nearby Vault with some of the survivors from the evacuation center . Sometime later Nancy Kroydon took her NCO ' s advice and set up quarantine for the worst of the radiation victims in an effort to calm the other survivors and patients who did not know that radiation poisoning was not contagious and were becoming increasingly worried . It also made it easier for the staff to smuggle the bodies out at night . With supplies dwindling fast , the unit was running out of Prussian Blue for treatment of radiation victims . Nancy Kroydon dispatched a group of the National Guardsmen to a nearby cancer treatment facility to get additional supplies , though she recognized that new supplies would at best stave off the inevitable ; widespread radiation poisoning . The National Guardsmen never returned and presumably either died or deserted , leaving Response Unit MD - 478 on its own and without desperately needed supplies . At this point whisky was used as a supplement to painkillers and the situation was so bad that the nurses and doctors could do nothing more than make the patients comfortable and await the end . Not long after , Nancy Kroydon died of radiation poisoning . To the end she regretted how she could not have been the last to go so that she could have helped the remaining staff and patients before they died . The fate of the rest of Response Unit MD - 478 is unknown , but the unit most like disintegrated and ceased to exist as personnel fell victim to the nuclear fallout or deserted . Some might have eventually integrated into the settlements that arose following the aftermath of the war , but the majority most likely died . Appearances . The National Catastrophe Relief Auxiliary - Response Unit MD - 478 is only mentioned in " Fallout 3 " .