This perk is given as possible reward for the quest The Way Life Should Be.
- When your health falls below 20%, do 4x damage for 30 seconds.
- The perk 02c9b4 is the actual perk given to you by completing the quest.
- The perk 02c9af is the 4x damage multiplier that occurs when your health falls below 20%.
- It is possible through the use of console commands to enable the 4x damage multiplier permanently.