Empathy is the "almost magical" emotion that persons or objects arouse in us as projections of our feelings. Empathy requires passion, more so than does equanimity, so long cherished by physicians. Medical students lose some of their empathy as they learn science and detachment, and hospital residents lose the remainder in the weariness of overwork and in the isolation of the intensive care units that modern hospitals have become. Conversations about experiences, discussions of patients and their human stories, more leisure and unstructured contemplation of the humanities help physicians to cherish empathy and to retain their passion. Physicians need rhetoric as much as knowledge, and they need stories as much as journals if they are to be more empathetic than computers.

In response to the articles in this issue about measuring physician empathy by Hojat and colleagues, Di Lillo and colleagues, and Kataoka and colleagues, this commentary further explores the concept of empathy. It is posited that empathy is an emotion important to medical care, but it is emphasized that it really doesn't matter whether empathy is a thought or an emotion. Retaining or enhancing it in medical care givers is worth doing and may be achieved through (1) the selection of medical students and others who will care for the sick, (2) the training caretakers receive, and more fundamentally even, (3) reconsideration of what doctors do in a world so much changed and so diverse.Empathy is the foundation of patient care, and it should frame the skills of the profession. It may be that empathy can be taught by example, but the minds of students, like soil, must be prepared before they can nourish seeds of knowledge, and in some soils little grows. Physicians must have the time to listen to their patients. Listening can create empathy--if physicians remain open to be moved by the stories they hear. Empathy has always been and will always be among a physician's most essential tools of practice.

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