It’s 2:00 AM on a Saturday in the Medical Intensive Care Unit. The incessant hum of monitors is a familiar soundtrack to your shift. With relatively few disturbances at this hour, you are taking the opportunity to catch up on filing patient paperwork, occasionally tapping your pen to match the rhythm of the monitors. Your focus is broken when the lead nurse, Sarah, approaches you with a look of concern.

“Doctor, I need you to look at Marcus in bed 4,” Sarah says. “His urine output has been virtually zero for the last three hours, and his ventilator keeps alarming for high peak airway pressures.”