And I really need it because I can't see half the enemies on a map. For instance, in the trapping area in Klamath, my cursor doesn't let me move any further, but I get aggrod and have to end my turn three times before a gecko even comes into view.
Anyone have the patch?

http://www.nma-fallout.com/forum/viewtopic.php?t=42386 no?

Oh nice, there it is. All the links I found here and on Google were broken.

Actually it's the first link if you google for "fallout high res patch" :)

I installed the patch and tried it in 800x600, but I still have the same problem, there are a lot of mobs off the screen. Is this just something I'm going to have to live with? Will there be any major impediments to completing the game?

Have you tried setting these in the f2_res.ini file?
IGNORE_MAP_EDGES=1
IGNORE_PLAYER_SCROLL_LIMITS=1
The game is also more fun if you don't just go around wiping out entire towns, you know. :P