At a certain point, if Lily Bowen is the players' active companion, the player may begin to hear a recording of children greeting their grandmother. This signals the start of Lily's unmarked quest. The playback of the recording of her grandchildren occurs when the following conditions are all satisfied:
You have talked to Lily about Leo and replied about it (generally available in her typical dialog tree asking her about herself)
You have witnessed her suffer a psychotic break during combat whereby she goes into a state of near frenzy, when her health is reduced to at least half, and talked with her about it.
You have witnessed her taking her medicine and talked to her about it. She says "Medicine Time" or "Grandma has to take her pills now, Dearie" when she takes her medicine.
Note: You have to ask her about herself (again) to get the appropriate medicine dialogue.
To complete the quest, the player must listen to the entire recording and then open a dialogue with Lily. After asking her several questions and discovering that she has only been taking half the recommended dosage of her medicine, the player is given three choices:
Recommend that Lily begin taking the complete dosage. If this option is chosen, Lily will stop suffering psychotic breaks altogether, but her Melee Weapons skill is reduced to 60 - these remain in effect regardless of her mental state.
Recommend that Lily continue to take half her dosage. If this option is chosen, Lily will continue to suffer psychotic breaks when she is reduced to one-quarter of her health, but will now calm herself immediately if the player enters Sneak mode.
Recommend that Lily stop taking her medicine altogether. If this option is chosen, Lily will now suffer psychotic breaks when reduced to one-half of her health, but her Melee Weapons skill is boosted to 100 - these remain in effect regardless of her mental state.
The player's choice will also have an effect on which game ending she receives.