Tuesday, July 13, 2010

“How are you doing?”

This is not to be confused with Joey’s signature pickup line on Friends. Completely different context.
Also, this is not to be confused with the common greeting “how are you?” People actually state “how are you.” They don’t ask it. The acceptable responses are:
“Good, how are you?”
“Fine, thank you.”
or similar.
Here are some unacceptable responses to the greeting “how are you?”
“None of your effing business.”
“My Aunt Eunice died.”
or any response that assumes the other person is actually interested in the details of your private life.
But this post is not about answering the question/greeting “how are you?” This post is about the much different question “how are you doing?” With the addition of a single word, the phrase transforms from an innocuous greeting to a loaded question, especially when it is asked of someone with MS or an equally terrible condition (like cancer, Lou Gehrig’s disease, or a faithful devotion to Cleveland sports teams).
When someone asks me “how are you doing?” I have a decision to make. Do I tell them the truth, or do I give them a canned response? It depends.

I believe that most people who ask me this question sincerely want to know the answer. They wonder if the disease is progressing. They wonder if I’m coping well. They wonder if I’ve found an effective treatment yet. And I believe that most people who ask me this question do so altruistically. They like me, and they hope for good news. I suppose a few of them may ask me how I am doing because they covet my wife or my shotgun, or both, and wish me a short life. Perhaps they remember when I gave them a wedgie in Junior High and consider news of my misfortunes as their retribution. I suppose that occasionally the person asking is secretly hoping for a sensational bit of news or gossip from me, just because they are the gossiping type. But these negative reasons are by far the exception (I hope).

If I choose the easy route, my canned responses are “good” or “hanging in there” or “about the same.” These responses require almost no effort- I’m talking about emotional effort- on my part. I reserve the right to respond with minimum exertion whenever I feel like it. Just because someone invites me delve into the gory details does not obligate me to do so. I give the canned responses when: it’s an inappropriate question because I don’t have a close relationship to the person, if the person asks me that question too often (even if we are close), or if I’m simply not in the mood to answer.

I reserve the more honest, detailed, forthcoming responses for when I have the emotional energy in reserve, and am willing to expend it. These complete answers often result in uncomfortable moments. I don’t like uncomfortable moments.

One of the highlights of my day is connecting with people that I care about. It raises my spirits. Now that I don't work, friendly human interactions are fewer. So if you immediately ask me how I am doing, you might be ruining the highlight of my day, which is connecting with you.
Here's my advice on when you should ask somebody like me “how are you doing?”
  1. Ask me if it's been a long time since you last asked me (but never asking me is almost as bad as asking me too often).
  2. Ask me if I am the one to raise the issue of my health (or your health for that matter).
  3. Ask me in a more specific manner if you can. For example, if you know that I went to New York for a procedure last week, instead of asking me “how are you doing?” ask me “how did that procedure go in New York last week?” The more specific questions require less emotional energy to answer than the more nebulous “how are you doing?”
  4. Ask me later in the conversation, after the excitement of reconnecting with you has begun to wane. Don't ruin the magical moment when we reconnect. Let’s talk about the good stuff first.
  5. Ask me at a bar, over drinks.
  6. Ask me in your private jet, on our way to Maui for an all-expenses-paid vacation.
This reminds me of a more general list I posted a few months ago, called How to Interact With a Disabled Person: 101. So many rules, Mitch? I know. It’s a complex game.

My goal here is not to have you walking on eggshells around me. I am not thin-skinned, and I’m not easily offended. In fact, please do ask me once in a while, “how are you doing?” It shows you care, and maybe I do want to talk about it. If I don’t, I’ll simply give you a canned response. I won’t be offended.
Clear as mud, right?

Just keep in mind. When you ask someone with a progressive disease “how are you doing?” you are asking a lot. Are you ready for the answer?


  1. Hi, Mitch,
    So, how ya doin'?
    Sorry -- I couldn't resist!
    I just wrote a similar blog a few weeks ago, and after I did, I began to watch how often people asked me how I was. Amazing! It's a constant question. So, I usually just say, "Pretty good." Like you, when I reconnect with an old friend, I let them lead the questions, and I try to be honest -- "It's really crappy that I had to stop working at a job I loved." or "I hate the fact that I can no longer write, paint, draw..." or "It can get depressing, knowing you'll never get well." If these are my true friends, they commiserate with me, and don't start fumbling for words.
    Sorry -- I didn't mean to write a whole post here!
    I, for one, do hope you are doing well today!


  2. I like this post. Similar thoughts.

    Words are important.

  3. I use "As you see." or "Remarkably well today ... under the circumstances" and sometimes, You know, I feel great today." Occasionally I just shoot them a direct in their eyes glance and say nothing. LOL But usually I say, "Just fine, and you?"

  4. I just smile and say, "ohhh.... better than some, not as good as most-- and how are you?"

  5. So...how are you today? (sorry I couldn't resist!)

    WELL....I could (but am biting my tongue) say plenty (but won't..well maybe a little) on this as it relates to the loss of a child AND having MS. Gee folks, when I say I lost my daughter don't walk away in silence. That's akin to a slap.

    Okay I didn't mean to blog-nap your comment box.

    But you do have a cool wheelchair. =)

  6. I always laugh to myself when this question is asked by my doctor's nurse. Does she really want the real answer as we walk down the hall to the room? I feel like an idiot when I say fine, obviously I'm not fine or I wouldn't be here!
    Thanks Mitch! How you doin'?

  7. Muffie,

    Fine, how YOU doin? :-)


    Words are indeed important, but sometimes we expend so little effort choosing them.


    "As you see." I like that one. I'm sure it's most effective with an open palm gesture toward your own body.


    I like your answer too!

    Have Myelin,

    That gives me an idea, "I'm doing crappy, but have you seen my wheelchair?"


    Yes! Even the medical community asks us the question when they may not want to hear the answer,

  8. It's been a while since I visited your blog- read several posts today.

    Love your down-to-earth writing style!

  9. Manju,

    Thanks for stopping by. I checked out your blog- loved it.

    I've been distracted from this blog of late, but hope to recommit myself soon.