Please answer using spoiler tags.
This quest somehow is similar to http://fallout.wikia.com/wiki/Solve_the_Gecko_powerplant_problem in Fallout2.
-You could commit genocide to the Ghouls living there either by shutting off the coolant yourself, or conning one of the reactor's tenders to do it for you.
-You could repair the reactor yourself (risking death) or by using the robot to fix it.
-You could repair and then optimize the reactor if you were skillful enough. This would lead to Vault City invading Gecko and enslaving ghouls (if you didn't negotiate a trade agreement between Gecko and Vault City)
These choices lead to different endings, so it made sense solving these problems.