A doctor would walk in, having heard of all this already and ask "How are you?"
Sometimes she gave them the benefit of the doubt, and sometimes she was a bit less charitable.
My point? Americans (as she was), Russians, Ukrainians, Latvians, Japanese, Kurdish, Bolivians, Icelandians, Koreans, Germans, Chinese, Scottish, Irish, Australians, Austrians, Swiss, South Africans, Egyptians, Mixolydians, Bohemians, and even Canadians all agree one one thing:
Being asked "How are you?" is the LAST thing somebody wants to hear when they are suffering.