Yes, the correct word is 'how.' Twitch streamer T Ronix - real name Mike - has managed to make his way through the violent commonwealth of Fallout 4 without a single hit. In what he calls quite rightfully 'The mother of all Fallout challenges' T Ronix managed to get through the whole game with only a glitch killing him at one point. You can see the final section of his playthrough below and it's ridiculous, not to mention tense.
You can watch the full playlist here but this level of Fallout 4 survival isn't new for T Ronix. His Twitch channel is purely for streaming his insanely challenging quests. He's already completed a perma-death no healing run in survival mode and a no perks, no companions run in survival mode version. Then there's the run where he only used his fists. There's even currently plans for a Skyrim perma-death legendary mode and one for the Witcher 3. That should keep him busy.
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