I preordered this through Amazon with free delivery, so I was expecting it to arrive sometime next week. Instead, it arrived today (hurrah, etc). So far I've played for about 3 hours (at which point, more or less, the game crashed), and am still in Goodsprings.
It's OK so far, but it has yet to really impress me particularly. Partly I'm still figuring out the controls/etc, not having played FO3. The writing is pretty good so far, the graphics are fine (although people all look slightly bizarre), and the sound design is overall pretty good. I find myself in agreement with Darth Parametric about having to walk - or run - everywhere - it's slow and dull.
One oddity I've run into so far is that 16:9/1366x768 aspect ratio/resolution messes with screenshots horribly, so have had to switch to 1280x720; not sure why, but it's nothing major.
Anyway, screenshots of the Amazon pre-order bonus (tribal pack) below, for people who haven't seen it:
The pack consists of tribal raiding armour, a broad machete, five bleak venom doses and ten throwing spears.