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Caesar sleeps but doesn't awaken. I fear it is only a matter of days before death claims him.Lucius

Et Tumor, Brute? is a main quest in Fallout: New Vegas.


Caesar has been experiencing intense headaches and blackouts more frequently as of late and asks for diagnosis and treatment of his ailment.

Quick walkthrough

Main Quest: Et Tumor, Brute?
Find a way to cure Caesar's brain tumor.
Decide to repair the Auto-Doc so it can do the procedure.
Decide to use your own medical knowledge, or your luck to do the procedure yourself. Need to pass a Speech check of 65, or a Medicine check of 75.
Sell Arcade Gannon into slavery as Caesar's personal doctor.
Go to Vault 34 and find a replacement diagnostic scanning module for the Legion's Auto-Doc.
Buy a doctor's bag, and surgical tools from the New Vegas Medical Clinic. You could also steal the tools from the first aid box in the room left of the counter.
Pass a Luck check of 9, or a Medicine check of 75.
Kill Caesar during the operation.
Leave Caesar unharmed during the operation.
To remain friendly with the Legion after Caesar's death, you must pass a skill check (Speech 50, Medicine 50, or a high Legion reputation) when speaking to Lucius.
Reward: 1,000 XP, Legion fame
Reward: 1,000 XP, Legion fame, 10 Aureus
Reward: 1,000 XP, Negative Karma, 10 Aureus.
Leads to: Arizona Killer

Detailed walkthrough

After wiping out the Brotherhood of Steel as part of the Render Unto Caesar quest, Caesar asks the Courier to meet him in his tent privately. Caesar explains that he has been suffering from debilitating headaches, his left leg has been dragging, the Courier has noticed him blank out, and that Lucius has said that he stares into space. The player character can properly diagnose him through either a 50 Medicine or 60 Speech check followed by 75 Medicine and 65 Speech checks. Caesar asks them to gather the proper tools and hurry back or asks who can help him if the first Medicine check or the Speech checks were failed, initiating the quest. Whether the player character passes the skill checks or not, they can ask about the Auto-Doc in his tent. Caesar explains that it is missing its diagnostic scanning module and that one may be found in Vault 34. If Arcade is a current companion he can also be offered immediately into slavery as Caesar's personal physician, skipping the quest but making him permanently unavailable for recruiting.

If Caesar's 50 Medicine check or 60 and 65 Speech checks were passed, then it is possible to use a set of surgical tools and a doctor's bag for the operation. The surgical tools can be bought from Dr. Usanagi at the New Vegas medical clinic for 999 caps or stolen from a first aid box on a stretcher in the adjacent room. If the skill checks were failed then neither the surgical tools nor the first aid box will spawn, and any option involving performing the surgery alone will not be available.

The diagnostic scanning module Caesar refers to is the automatic surgical unit. It can be found in the clinic room of Vault 34, located northwest of Camp Golf and east of NCR sharecropper farms. When first walking into Vault 34, take the first right to the stairway that will lead to the cafeteria. Drop down the hole in the floor, exit the room, and turn left. Follow the corridor and the signs for "clinic". The Auto-Doc is on the back wall. Interact with it and the option to take the item will appear.

Upon gathering either the surgical tools or the automatic surgical unit and returning to the Fort, Caesar is in a coma and is near death. Only an operation to remove the tumor from his brain will save him. There are several options to finish this quest:

  1. Use the surgical tools in conjunction with a doctor's bag. The operation will only be successful if the Courier has 75 or higher Medicine skill, otherwise, Caesar will die.
  2. Trust in one's luck and perform the operation. Having the above items and 9 Luck is required for the option to be shown and the operation will always be successful.
  3. Install the automatic surgical unit into the Mark III Auto-Doc in Caesar's tent. After installation, one can choose to activate the surgery mode to successfully remove Caesar's tumor or activate autopsy mode, which causes his head to explode, killing him.
  4. If the first opportunity to sell Arcade into slavery was passed on, it is still possible to sell him later to Lucius. The screen will fade to black, and when the scene resumes, Caesar will be cured. This is not possible on PC due to a game breaking bug (see Bugs).
  5. Arrange for Caesar to die during the surgery.

If Caesar lives, he will thank the Courier for saving his life, and will then move on to give the Arizona Killer quest.

If Caesar dies, Lucius will confront the Courier and accuse them of killing him. With a Liked or higher reputation or passing either a Medicine 50 or Speech 50 check, it is possible to convince Lucius otherwise and remain friendly with the Legion, or else they will become immediately hostile.

Quest stages

10 Acquire a set of surgical tools.
11 A Doctor's Bag is also necessary to perform the surgery.
15 Acquire a functional diagnostic scanning module for Caesar's Auto-Doc.
20 Perform brain surgery on Caesar to remove the tumor which is killing him.
25 (Optional) Kill Caesar during the procedure. It might look natural...
30 Install the replacement diagnostic scanning module into Caesar's Auto-Doc.
35Quest finishedUse the Auto-Doc to cure Caesar.
40Quest failed(Optional) Use the Auto-Doc to kill Caesar.
45Quest finished(Optional) Have Arcade Gannon enslaved as Caesar's personal physician.


  • The broken Auto-Doc may be in security station A instead of the clinic.
  • One has the option of checking the Mark I Auto-Doc at the New Vegas medical clinic, but a message will explain that despite its similarities to more advanced models (such as the Mark III in Caesar's tent), it is obsolete and shares no compatible parts.
  • If the Courier performs the surgery with an insufficient Medicine skill between 25-74, Caesar will always die in the same manner as if the option to arrange for him to die was selected. Performing the surgery with an even lower Medicine skill will result in Caesar's head humorously exploding, offering unique dialogue from an enraged Lucius that will always end with him and the Legion becoming hostile.
  • Attacking Caesar while he is in his coma will result in him instantly awaking hostile and he will either be stuck standing still or ready to attack the Courier. If they are hidden for a sufficient amount of time Caesar will lay back down as if he were sleeping rather than in a coma, and he will wake up and attack if he notices the player character again.
  • Attempting to pickpocket Caesar in his coma will still result in the surgery options showing.
  • Punching or shooting Caesar's body after he dies from the surgery will result in everyone in the tent becoming hostile.
  • It will be impossible to offer Arcade Gannon to Caesar as a slave if he was recruited after having spoken to Caesar in private. He can still be offered to Lucius once Caesar has gone into his coma, or immediately after killing Caesar in his coma.
  • If Arcade was lost as a companion by betraying him in For Auld Lang Syne, sometimes the option to sell him into slavery will still be present. Speaking with Caesar, and then Lucius, one will then be able to successfully sell Arcade into slavery, despite not having had to leave the tent, or even having access to Arcade. This will give the normal quest reward for selling Arcade into slavery.

Behind the scenes

  • The title of this quest is a play on Julius Caesar's famous last words, "Et tu, Brute?" from the Shakespearian play Julius Caesar which translates to "And you, Brutus?," showing Caesar's dismay in seeing Brutus taking part in his assassination and betrayal.
  • The quest is an elaborate allusion to Julius Caesar, who did indeed suffer from an ailment that caused severe headaches and was also a secret from the public. Caesar's headaches were more likely to have been caused by a motor function disorder, causing him to fall regularly ("falling sickness"). Other theories on this include epilepsy, migraines, and even malaria.
  • If after Arcade is given as a slave the player character speaks to him and says "The world needs Caesar more than it needs you" Arcade will respond "Victrix causa diis placuit sed victa Catoni" which can be translated as "the victorious cause pleased the gods, but the conquered [cause] pleased Cato." This is a quote from the Latin poem Pharsalia by Lucan, in which the historical figure of Caesar is portrayed as the main antagonist, and the main hero, the historical figure of Cato Uticensis, is eventually forced to commit suicide, being unable to defeat Caesar.


PCPC Completing the quest via offering Arcade Gannon to Lucius causes a show-stopping bug whereby Caesar is not woken from his coma and is permanently stuck. Only his coma message box will show when interacting with him even though that quest is marked complete. The reason is a developer omission of 3 lines of scripting for that specific quest outcome.[verified]

Main quests
Act 1Ain't That a Kick in the Head · Back in the Saddle · By a Campfire on the Trail · They Went That-a-Way · Ring-a-Ding-Ding!
Act 2Wild Card (Wild Card: Ace in the Hole, Change in Management, You and What Army?, Side Bets, Finishing Touches) · The House Always Wins (I, II, III, IV, V, VI, VII, VIII) · Render Unto Caesar · Et Tumor, Brute? · Things That Go Boom · Kings' Gambit · For the Republic, Part 2 · You'll Know It When It Happens/Arizona Killer
Act 3No Gods, No Masters · All or Nothing · Veni, Vidi, Vici · Eureka!
Side quests
New California RepublicAnywhere I Wander · Back in Your Own Backyard · Bitter Springs Infirmary Blues · Boulder City Showdown · Can You Find it in Your Heart? · Climb Ev'ry Mountain · Don't Tread on the Bear! · Emergency Radio · Eye for an Eye · Flags of Our Foul-Ups · Hard Luck Blues · I Don't Hurt Anymore · I Put a Spell on You · Keep Your Eyes on the Prize · Medical Mystery · No, Not Much · Pressing Matters · Restoring Hope · Return to Sender · That Lucky Old Sun · The White Wash · There Stands the Grass · Three-Card Bounty · We Will All Go Together · You Can Depend on Me
Caesar's LegionBeware the Wrath of Caesar! · Caesar's Favor · Caesar's Foe · Caesar's Hire · Cold, Cold Heart · I Hear You Knocking · The Finger of Suspicion · We Are Legion
The StripBeyond the Beef · Bye Bye Love · Classic Inspiration · How Little We Know · Pheeble Will · Talent Pool · The House Has Gone Bust! · The Moon Comes Over the Tower
Freeside & Outer VegasBirds of a Feather · Bleed Me Dry · Debt Collector · G.I. Blues · High Times · Someone to Watch Over Me · The Coyotes · Wang Dang Atomic Tango
BoomersAnt Misbehavin' · Sunshine Boogie · Volare! · Young Hearts
Great KhansAba Daba Honeymoon · Cry Me a River · Don't Make a Beggar of Me · Oh My Papa
Powder GangBooted · I Fought the Law · Run Goodsprings Run · Why Can't We Be Friends?
Brotherhood of SteelEyesight to the Blind · Still in the Dark · Tend to Your Business
OtherCome Fly With Me · Crazy, Crazy, Crazy · Ghost Town Gunfight · Guess Who I Saw Today · Left My Heart · My Kind of Town · The Legend of the Star and A Valuable Lesson · Unfriendly Persuasion · Wheel of Fortune
Companion questsED-E My Love · For Auld Lang Syne · Heartache by the Number · I Could Make You Care · I Forgot to Remember to Forget · Nothin' But a Hound Dog · One for My Baby
Unmarked questsA Bit of Slap and Tickle · A Final Plan for Esteban · Access Powers · All Fired Up! · An Ear to the Ground · Andy and Charlie · Arachnophobia · Arizona Scavenger · Barton the Fink · Bear Necessities · Big Winner (Atomic Wrangler, The Gomorrah, The Tops, Ultra-Luxe, Vikki & Vance) · Bounty Killer (I, II) · Brotherhood Bond (I, II) · Caching in at the Cove · Cajoling a Cudgel · Claws Mended · Claws Out · Dealing with Contreras · Defacing the Humble Stone · Democracy Inaction · Don't Poke at the Bear! · Eddie's Emissary · Exhumin' Nature · Fight Night · Flogging a Dead Corpse · Friend of the Followers · Gland for Some Home Cooking · Harder, Better, Faster, Stronger · Hat's Entertainment · Help for Halford · Hidden Valley computer virus · Highway to the Danger Zone (I, II) · Honorary Rocketeer · I Love Bananas · Iron and Stealing · Keith's Caravan Charade · Laurifer Gladiator · Lenk's Bad Debts · Lily and Leo · Long-Term Care · Malleable Mini Boomer Minds · Maud's Muggers · Meeting an Equal · Missing a Few Missiles · Most Wanted · Not Worth a Hill of Corn and Beans · Old School Ghoul · A Pair of Dead Desperados (I, II) · Papers, Please · Pistol Packing · Playing on the Old Joana · Poor Meat Never Makes Good Soup · Powder to the People · Power to the People · Razzle Dazzle! · Reach for the Sky, Mister! · Rest and Resupply · Ringo's Caravan Rules · Rotface's Loose Lips · Saving (or Savaging) Sergeant Teddy · The Screams of Brahmin · Silus Treatment · Short-Term Treatment · Smooth-Talking Criminal · The Star Showdown · Strategic Nuclear Moose · Straus Calls · Strip Search · Suits You, Sarah · Tags of Our Fallen · A Team of Moronic Mercenaries · Thought for the Day · Tourist Traipse · Trudy's Radio Repair · A Trusted Aide · Useless Baubles or Fancy Trinkets? · We Must Stop Beating Like This · We Must Stop Meeting Like This · Wind-Brahmin Wrangler · You Gotta Break Out a Few Eggs · You Make Me Feel Like a Woman
Add-on quests
Dead MoneySierra Madre Grand Opening! · Find Collars (8: "Dog", 12: Christine, 14: Dean Domino) · Fires in the Sky · Strike Up the Band · Mixed Signals · Trigger the Gala Event · Put the Beast Down · Last Luxuries · Curtain Call at the Tampico · Heist of the Centuries · Big Winner, Sierra Madre
Honest HeartsA Family Affair · Arrival at Zion · Bighorners of the Eastern Virgin · Chaos in Zion · Civilized Man's Burden · Crush the White Legs · Deliverer of Sorrows  · Departing Paradise · Flight from Zion · Gathering Storms · Gone Fishin' · Happy Trails Expedition · Prisoners of War · Retake the Bridge · River Monsters · Rite of Passage · Roadside Attraction · Sanctity of the Dead · The Advance Scouts  · The Treacherous Road · The Grand Staircase · Tourist Trap
Old World BluesAll My Friends Have Off Switches · A Brain's Best Friend · Coming Out of Her Shell · Field Research · He Came... And Went · Influencing People · Midnight Science Fiction Feature! · Old World Blues · On the Same Wavelength · Picking Your Brains · Project X-13 · Sonic Emitter Upgrade · Welcome to the Big Empty · What's in a Name? · When Visitors Attack! · X-2: Strange Transmissions! · X-8 Data Retrieval Test · X-8: High School Horror! · X-13: Attack of the Infiltrator!
Lonesome RoadThe Reunion · The Silo · The Job · The Launch · The Tunnelers · The Divide · The Courier · The End · The Apocalypse