Yeah no clue. I tried a lot of the solutions I found in the forums on Steam and the Fallout site, tried downloading some patches yada yada and finally just gave up.
Every other game I've had works, and it seems I'm not the only one having the problem, so no idea. Like you said, my laptop probably just doesn't have a video card high enough to run it or something.
Weird, I never had issues with the game when I had it installed. Since you said you tried a few solutions, I'll go with something simple and ask if you selected XP compatibility?
Also did you follow these steps?