But its very different depending on the person. Some can not feel empathy at all. They still need to navigate this world without exposing themselves, thus they have to emulate empathy by mimicry. Should even be detectable as a delayed response.
And unfortunately, a lack of empathy is often confused for a lack of care, or a lack of kindness. There's no particular reason the two have to be intertwined. In fact, I'd go so far as to say that if you cannot care for someone without feeling empathy towards them, then this represents a deficit.
One very comon though. Humans run out of social capability once a tribe/village exceeds a certain size. This is why patriotism is such a important thing, its basically snythetic empathy for your whole tribe, no matter how huge it is.But it can be derailed pretty badly.