"When they say there's more than one way to skin a cat, I know," joked Addo, Washington County Hospital's vice president for patient care services and an unabashed dog person.
Uh-oh. That didn't sound compassionate and Hippocratic enough. Some of the 1,200 employees she oversees - especially the cat lovers - might get their backs up. Addo backpedaled a bit on cats.
"As I got older, I did learn to love them," she said with a laugh.
Addo, 43, looked back on that formative time, learning anatomy inside and out, as scientific curiosity trumping squeamishness.
"It was more the concept of what I was going to discover," she said.
Older brother Charles went on to be a fireman.
Michael, the oldest sibling, became an accountant.
Eighteen-year-old Lamont - a boy her mother adopted when Deborah, Charles and Michael were grown - is an aspiring musician.
Deborah pursued medicine.
The path to Hagerstown
Addo earned a combined biology and psychology bachelor's degree from Georgetown University, then a health-care administration master's degree from George Washington University.
Freshly graduated and 21 years old, she went to work for a startup behavioral sciences managed-care company in Washington. She was the office manager.
She moved on to jobs at Great Southeast Community Hospital in southeast Washington, and a gastroenterology group in Prince George's County, Md.
She then spent eight years with Children's Hospital in Washington.
She was the director of performance improvement and re-engineering at Children's Hospital. She described the first part as "incremental change" and the second part as "when you blow up the whole thing and start over again."
Something was "blown up" there?
"We rearranged services along service lines," she said. "We brought them under one umbrella."
For example, all of the people who might see or treat an asthma patient coordinated their work. One person oversaw the unit.
"At that time, people were just (starting to look) at case management," Addo said.
She joined Washington County Hospital as the director of case management in 1996.
It was a new work, looking at how high-cost, high-volume and high-risk cases - such as congestive heart failure, strokes, asthma and pneumonia - could be handled best.
Were patients taking the right medications? Getting the right follow-up treatment? Avoiding hospital admissions through preventative care?
Addo started out alone in her department. Soon, there were 12 case managers working with her.
After six months, the vice president for patient care services left. Addo filled in until a replacement was found.
When the new vice president left, Addo again stepped in. She said she "wasn't at all interested" in keeping the promotion.
As an interim vice president, she spearheaded the development of the Center for Joint Replacement, which uses an integrative approach similar to her work at Children's Hospital. Surgeons, occupational and physical therapists, nurses, pharmacists, social workers and nutritionists work together.
"To get eight orthopedic surgeons on the same page - that was a major accomplishment," Addo said.
Patients prepare for surgery together, then go through outpatient services together afterwards.
"The program has clearly demonstrated decreased length of hospital stay and improved recovery rates, getting people back to normal functioning as quickly as possible," the hospital's Web site says.
Addo oversees the hospital's home health care, extended care, "informatics" (new technology), nursing, in-patient support services, Total Rehab Care and Behavioral Health Services departments - plus health management, her old department.
"Staff meetings are a lot longer," she said.
But Addo enjoys being busy - stretched, even.
"When I'm at home, I'm watching TV, talking on the phone and reading at the same time," she said.
"Maintenance bores me," she said as she checked her schedule on her personal digital assistant.
She translated: "I like to start up things."