I don't strictly know that Miko doesn't feel warm and fuzzy about helping people, I just don't think it's the be-all and end-all of virtues, and that politeness/etiquette is a surprisingly weak predictor either way.

Empathy isn't a bad thing to have, but it comes with it's own drawbacks, such as the risk of burnout or manipulation, which tend to limit its scope and make it prone to misdirection. The reason why a lot of health professionals, for example, come off as cold and unfeeling to patients is precisely because they can't maintain close emotional rapport under those kind of stresses. Only the Oath endures.