Instructions
Talk with the doctor who rescues you at the beginning of the game; this is a forced conversation; you cannot break out of it until you finish selecting your skills.
Select the "Unarmed," "Endurance" and "Health" skills as the three tagged skills you wish to have.
Select "Health" and "Strength" for your two perk traits.
Select your bonus perks as "Nerd Rage" and "Strong Back." The combination of all of these skills, traits and perks will cause your melee combat to be maxed out from the start of the game.