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Explainable, retrieval-augmented LLM for clinical decision support. Classifies MIMIC-IV ED records into 10 body-system disease groups (MedGemma-4B + QLoRA, PubMedBERT+FAISS, Qwen2.5-14B explainer) with auditable, clinician-validated explanations. Macro-F1 0.7253 on a single 15GB GPU.