Howdy folks.
Running out of ideas here, but my game crashes back to the windows desktop after I attempt to leave Doc Mitchells' at the beginning of the game. I get the Roulette loading wheel, some billboards and then bam.

Here's my system:
OS: Win XP Professional 64-bit SP2
Processor: Intel Core i5 3570K @ 3.40
Memory; 16 Gigs, 380 Gigs of HD free
Video Card: Itenl HD Graphics 4000 with 1 Gig allocated
All drivers uptodate, ttbomk.

Fallout: NV
Vanilla game, no mods.
DLC: Dead Money, Honest Hearts, Old World Blues

Fixes attempted:
With Fragmentation @ 0%, verify integrity of game cache. Result: 1 file failed and redownloaded.
Unable to fix bad file: every integrity verification leads to the same thing.
Uninstall and reinstall NV. verify integrity of game cache. Result: 1 file failed and redownloaded.
No change.
Read up on possible .ini issue. Delete all .ini NV files. verify integrity of game cache. Result: 6 files failed and redownloaded.
verify integrity of game cache. Result: 1 files failed and redownloaded.
Wash, rinse, repeat...

Any insight?