Right away, you notice the things everyone notices about her. You meet in her office and are struck by how tiny she is. She’s barely five feet tall. And she’s so—a fact’s a fact—adorable: short curly brown hair, big brown eyes, cheeks rosy as rose petals. And what a smile. She’s dressed in different fabrics and different shades of creamy colors, and smelling of…well, cream. Or maybe it’s that she looks so creamy you just think she smells creamy. Regardless, this much is certain: Sixty-seven-year-old Dr. Patricia Gabow exudes all of the toughness of the Boy Scout den mother who always does all the work for the kids struggling to earn their merit badges.

You think: This is who walked into the tower of power, the office of political giant Denver Mayor Wellington Webb, and walked out with control of Denver’s city hospital, the second-largest city agency? This is who took over that Denver General Hospital, best known for its “Knife-and-Gun-Club” ER and for hemorrhaging money, and changed all that to Denver Health, a nationally recognized model of a public hospital?

You hear her speak, or rather do your best to hear her speak, as her conversational voice is little more than a whisper. It’s more like parched breath, so raspy her words sound as if they’re forced through a windpipe of sandpaper. “Please, call me Patti,” she says. It sounds as if it causes Patti great pain to speak. No kidding, when she talks your instinct is to hug her and say, “It’s OK, don’t strain yourself. Let’s go get you a cup of tea with some honey.”

This is the voice that has dressed down macho surgeons? This is the voice that has been summoned to testify before the U.S. Congress as an expert on providing government-managed health care? This is one of President Obama’s most influential voices on Medicaid?

Next thing you know, she’s crying. She’s explaining that her father died not long ago, and her mother, showing signs of dementia, has been moved to Colorado from Pennsylvania, and so Gabow recently went back to her parents’ home to clean out the place before it went on the market. She went halfway across the country and did this herself because she didn’t want to risk losing family keepsakes, like the letters from her biological father, whom she never got to know, and…her eyes fill up.

This is who one Denver Health doctor says has “ice water in her veins”? This is the CEO who, in 1992, began leading the hospital out of a $38.9 million deficit and into the black? She did that while Denver Health provided some $4 billion—$4 billion!—in uncompensated care, including $380 million in uncompensated care in 2010 alone. This lady is that CEO?

You accompany her to a senior staff meeting; both of you squeeze into an elevator packed with hospital employees. Riding down, apropos of nothing other than the fact that it’s morning, she breaks the awkward elevator silence by saying: “My husband once asked me in the morning, ‘Are you gonna have an “A” day today?’ ” Her voice still sounds strained, but no longer weak. Apparently amplified by some strategically invoked ability to project—not merely her voice, but all of who she is—there’s an oomph in her tone that snaps back shoulders, commands attention. “And I’d say, ‘Yes.’ And he’d say, ‘Well, how do you know?’ And I said, ‘Because I’m the one giving out the grades.’ ” There’s a few prolonged seconds of silence, and then the elevator doors open and she walks off.