The title question is not to be confused with the more common greeting “how are you?” Under no circumstances should you respond to “how are you?” as if the questioner gives a damn about your personal life. Acceptable responses are:

• “Good.”
• “Good, how are you?”
• “Fine, thank you.”
• or similar drivel

By adding only one word — “How are you doing?” — the innocuous greeting becomes a loaded question, especially when directed at someone with MS or an equally challenging condition. When I am asked, “How are you doing?” I have to make a decision. Do I undertake the hard work of telling the truth, or do I give a canned response? It depends.

I believe most people who ask me this question do so with sincerity. They wonder if the disease is progressing. They wonder if I’m coping well. They wonder if I’ve found an effective treatment. And I believe most people who ask me this question do so with compassion. They care about me, and they hope for good news.

Nevertheless, I reserve the right to give a canned answer such as “good” or “hanging in there” or “about the same.” I may not have the emotional energy to go any further at that moment. Just because someone invites me to delve into the gory details does not mean I am obligated to do so.

Still, if you are sincere and compassionate, here’s some advice on asking somebody like me “How are you doing?”

• Ask me “How are you doing?” if it’s been a long time since you last asked me.
• Ask me if we are close friends or relatives.
• Ask me if you are similarly afflicted.
• Ask me if I am the one to raise the issue of my health (or your health for that matter).
• Ask me in a more specific manner if you can. For example, if you know that I went to the cancer center for an infusion last week, instead of asking me “how are you doing?” ask me “how did that procedure go last week?” The more specific questions require less emotional energy to answer than the more nebulous ones.
• Ask me later in the conversation, after the excitement of reconnecting with you has begun to wane. Let’s talk about the good stuff first.
• Ask me at a bar, over drinks.

Also 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?