Maou na Ore to Fushihime no Yubiwa - Volume 4 Chapter 4 — Onsen!

I was reincarnated in a game-like otherworld.[ Warning! When acquiring an active skill, all stats will decrease by 80% for each active skill! ]...What the hell.

Orlax Tirshtain is the villain in the global game [Unification of Empires]. The tyrannical, cold-blooded emperor is a man who slaughtered his own family with his own hands and ascended the throne with their blood—a power-obsessed madman. Despite five years having passed since the game’s release, no one has been able to defeat this lunatic. So, how the hell did I become this damned?????

Survival is easy. Life is very difficult. My family wants not to live in humility, but to live a proud and glorious life. My family, will not be slaves!

- Description from Novelupdates

A Di [legitimate-born] daughter of a noble house turns into an abandoned daughter. No father to dote on her, no mother to love her, no problem. She uses one silver needle to save a dying man. What’s so unusual about a medical injection? She roams all over the world with a scalpel in her hand. Cutting throats, cutting open abdomens, cutting open skulls to mend bones. With amazing medical skills and ethics, she gathers a flock of officials, obtains the will of heavens, gains public favor, and receives Taizi’s [Crown Prince] doting. In the midst of a powerful momentum, her cheap father comes to reunite. She coldly refuses to go home or acknowledge ancestors.