When patients make requests forcefully, it is easy for an unskilled clinician to be pushed off balance. A forceful request often carries an undercurrent of hostility that throws oncologists who are used to being treated with deference. We do not like this, and consequently, hostility from the patient tends to provoke hostility from the clinician. For clinicians who have not been trained to detect and respond to emotion as a core communication skill, it is easy to fall into the trap of responding defensively or angrily. From the outside, this skill can look like magic because it is subtle—it starts with self-monitoring.2 The key skill is to notice when you are irritated, and rather than blurt out your defense, pause and step back for a moment. You will then recognize that your patient who is demanding something is actually upset and hurting in a way that is overwhelming their coping skills or, much less often, has a personality such that they deal with everyone in their lives by making demands. A skilled clinician, after the pause, would start with an empathic remark (“Hmm, sounds like this is really important to you”) and modulate accordingly.3 For a patient who is really upset, the emotionally intelligent oncologist might offer more empathy (“I get the feeling you are worried…”) and uncover the real issue (“Yes doctor, I’m just scared”); and when the emotional tone fades, try the information again (“Could I step back—I’ll try to do a better job explaining my recommendations”).