You see my kind of loyalty is loyalty to one's calling, not to its institutions or its office-holders. The calling is the real thing, the substantial thing, the eternal thing; it is the thing to watch over, and care for, and be loyal to; institutions are extraneous, they are a calling's mere clothing, and clothing can wear out, become ragged, cease to be comfortable, cease to protect the body from winter, disease, and death. To be loyal to rags, to shout for rags, to worship rags, to die for rags--that is a loyalty of unreason, it is pure animal; it belongs to monarchy, was invented by monarchy; let monarchy keep it.

– Mark Twain

[In the passage above, I have changed Mark Twain's word "country" to "calling" to make the passage's message more obviously applicable to the practice of medicine. Twain's message to the monarchs and their vassals seems to be: “To the degree (and for the duration) that you can believe in the value of a certain calling and can support a rank and file person's heartfelt pursuit of it, you can enjoy some of the tangible fruits of this labor, and bathe in genuine appreciation for allowing great things to be done in your kingdom. To the degree that (or when) you don’t (or no longer) believe in the intrinsic value of the calling, people who have some form of magic burning in their hearts and minds will either move to a more supportive kingdom or use their magic to alter the leadership of this one” – EMS].