A friend directed me to the above screenshot from Fallout fansite Duck and Cover. It's from a forum post in an off-topic thread with a poll about the candidates in the Presidential election. At first, it looks really creepy, like someone's mocked up a tasteless and borderline racist anti-Obama note in Fallout 3.

But if you've played the game, you might recognize the note as loot from one of the Talon mercenaries who will attack you if your karma is high enough from doing good deeds. The player, who posts under the name VasikkA, has simply named his character "Barack H. Obama", and the game took over from there. It's still a little weird -- Barack H. Obama as the 19-year-old who emerges from Vault 101 in search of his father? -- but not quite "Quick, call the Secret Service!" weird.