I like miracle operation. So here's a build I like. There are some metagaming tricks you can do to get the best weapon for this character, but I won't talk about this here. I'll just talk about the start
Do Female Half-Elf: Miracle Operation.
2 into Firearms
1 into Pe
2 into DX
Not too worried about starting equipment. I think you get a pistol anyways. Either get more ammo or keep the gold.
First thing you do after starting the game. Go find virgil. He should be east (down i think from the crash). Next you want to clear the starting area. Do not go to the part south of the stone. Not for your character yet. Just the part around the blimp and in the nearby cave. There's a quest you can pick up. Do what you want with that. After getting all the loot you and virgil can carry. You might level once or twice. You should put points into
2 Strength
3 Strength
4 Firearms
5 DX and Firearms
Every fifth level you get an extra skill point. After killing everything (except wolves; go back later for more experience), go to the town Virgil points out. In the tavern/inn talk to the big half-troll or whatever he was. Recruit him into your party. Take good care of him. One of the best companions in the game. You need STR to get it to wield some pistols. In particular, a nice pistol you get as quest reward from helping the doctor. It's been a long time, but I think what I put above should let you wield it. This will be a hard start, but you should have fun with it.
Your goal here is to be the fastest gun in the west. Your most important stats are going to be Perception, Intelligence, Gunsmithing, Throwing, Firearms, Dexterity, and the stat that lets you make grenades (forgot which one). You should put about two points into Electrical to get the charged rings (best rings you could get, makes it so you don't need to put too much into dx). You also should put some points into STR as you find you'll need more STR to meet the requirements to wield certain firearms. However, you certainly don't need to use an elephant gun. Probably not a machine gun either. I'd just stick to pistols like the hand cannon and specific gun that you find later in the story (or you get the recipe for really early if you know where to look). You can also put a little bit of points into cha for more companions as well and perhaps some points into persuasion. What matters first is that as fast as possible, you want to get a hand cannon, two charged rings, and to push your Dx up to 16 (+4 from charge rings is 20), Pe up to 20, and Firearms up to 5.