How am I? I'm awful, how are you?
September 3, 2014 5:40 AM   Subscribe

A question about niceties when you suffer from chronic pain.

Back in may, I suffered a hemorrhagic stroke. While managing to avoid any severe neurological damage or impairment, I have been left with a chronic pain condition. My muscles hurt all day, every day.

My co-workers, both as part of regular greeting and out of friendly inquisitiveness will ask me "how are you?" I find myself torn between several competing imperatives:

1. I want to be honest.
2. I want to be friendly/polite.
3. I don't want to be "that guy who's always complaining about his health".

The answer I'm currently using is "Same as always, how are you?"

Chronic pain sufferers (and those who love them), what responses do you use in these (and similar situations), given my list of imperatives? Thanks.
posted by DWRoelands to Human Relations (33 answers total) 7 users marked this as a favorite
 
I'm sorry you're experiencing this. I don't suffer from chronic pain, but when I've been in long-term stressful situations my go-to response has been "Oh, I'm hanging in there, how about you?" Delivered with the right tone, this feels like it honors (in my head) the fact that I'm not really okay, while respecting the fact that "how are you?" is mostly just a polite question that doesn't really expect an honest answer.
posted by DingoMutt at 5:50 AM on September 3, 2014 [18 favorites]


I might rely on a platitude, such as "Mind is willing... How are you?"
posted by Draccy at 5:51 AM on September 3, 2014 [1 favorite]


I have had a chronic pain condition for 8 years now and I always let people know how my day is. If it is a "low" pain day, I tell them it is a good day. It is a good day since I hurt less. If it is a bad pain day, I am not really talking to people or I look bad and people are asking me what is wrong, so I do not mind telling them that it is a rough day. I am surprised by the amount of continual sympathy from people who know what I have. That said, I try to keep it brief since it never really stops. All things considered, I am just happy that I can leave the house and function, which is better than most people with chronic pain.
posted by Nackt at 5:51 AM on September 3, 2014 [4 favorites]


If it is part of the "Good morning, how are you?" "Fine, and you?" "Fine, thanks!" largely perfunctory call-and response, than I'd stick with the answer you're currently using, or select a non-answer that is true, but doesn't engage your colleagues in a deeper conversation than they'd intended.

If they ask you how you are feeling outside of that daily call-and-response, be honest, but don't dwell or overwhelm them with details, and warmly affirm the fact they are trying to care about you. "I'm struggling today. Thanks for asking."

Hang in there.
posted by arnicae at 5:52 AM on September 3, 2014 [7 favorites]


"How are you?" isn't a question, it's a greeting. And the proper reply greeting is, "Good, you?" Unless it's your best friend asking, and unless it's in a context where it's clear that they're really asking because they want you to tell them the honest and full truth, (e.g., "So, DWR, I know you've been having a rough time lately. How are you really doing?"), what they want is to go through the ritual, not to actually hear about your problems.

Also, as a note to people who ask this question: it's a stupid greeting. A better greeting is something like, "Hi" or "Hey, cool hat" or "I heard you did a great job on the TPS reports!" Something that doesn't really require a response, particularly a split-second decision about how much information to give. It's a pretty silly ritual.
posted by decathecting at 5:52 AM on September 3, 2014 [17 favorites]


I always think the answer to this question is a variable depending on your relationship with the asker. Essentially this can also be viewed as whether someone is really bothered about the answer or not. Generally, people you are doing business with are not interested in the answer, they are interested in doing business. In US and European societies there are niceties to start the conversation but they signify little beyond basic manners.

Friends are a different matter and you can be honest with them when they ask how you are.

Co-workers are somewhere in the middle. Some you have friendly relationships with and can consider something which hints at your actual state. Your CEO, co-workers you don't deal with very often, aren't on friendly terms with, have barriers due to status with, etc, not so much. I would even avoid the 'struggling today' line, people will take things from it that negatively colours there perception of you as regards being a potential shirker, etc, even if you do as much work as anyone.

The honesty thing may mislead you, it is not to anyone's advantage for you to be totally honest in many of these situations. As you are aware it might make you look like a moaner. It might also make you look more risky for leave due to illness. it might make others uncomfortable and look upon you negatively. Where's the upside of letting anyone know other than maybe friends and possibly your line manager in the case where you need any extra support?
posted by biffa at 5:59 AM on September 3, 2014 [1 favorite]


"Can't complain! You?"
posted by Omnomnom at 6:06 AM on September 3, 2014 [5 favorites]


Just because something is in the form of a question doesn't mean it's truly an interrogative. When you say to your kid, " can you take out the trash please?" you aren't asking them, you're telling them in a nice manner.

So figure out depending on who it is whether they are asking a question or exchanging a greeting. Your co-worker who you get along with but don't do anything social together is probably different than your best friend. Read between the lines.
posted by Aranquis at 6:16 AM on September 3, 2014


As others have said your response has to depend on your level of intimacy with the person asking. With a casual acquaintance who you don't particularly want/need to let into your life, the correct response is some variation on "Fine, and you?"

If you want to test the waters and see if the person is up for a more "real" answer, you can escalate to something like, "I'm feeling pretty rough today, how about you?" and then pay attention to how they answer. If they respond with genuine concern/interest, ok, go with that! If they deflect with something like, "Well, at least tomorrow's Friday!" then probably they were not really interested and don't much want to hear about the exact way in which your day is going poorly. If people don't want to get into it with you about how you feel, it doesn't necessarily mean that they're terrible people or anything, it just means they don't want to escalate their relationship with you.

I had a coworker who would always respond "honestly" to "how are you?" questions and it was very strange (especially since she mostly didn't have any real problems). I remember one time I asked her how she was doing and she went into this whole long thing about how she was so upset because had just learned that her daughter's friend's younger sister(!) had been diagnosed with cancer (and they said it was highly treatable, but how scary for a young woman, etc. etc.). It was sort of disorienting and off-putting to me since my aunt had been diagnosed with terminal kidney cancer a few weeks earlier and was not expected to live more than a few months, and I hadn't mentioned it to the coworker because I didn't feel like we were at a level of intimacy where she needed to know that about my life.
posted by mskyle at 6:23 AM on September 3, 2014


"Can't complain", "same as always", and "hanging in there" are all good.
posted by Sticherbeast at 6:55 AM on September 3, 2014 [1 favorite]


Agree that it varies by level of intimacy. You can also tell the difference by their intonation.

Stranger or acquaintance who doesn't know about your condition:
Intonation: "Hey, how are you?"
Answer: "Good! And you?"

Coworker or acquaintance who knows:
Intonation: "Hey, how are you?"
Answer: "Oh, pluggin' on along." or "Better than I was!"

Coworker or acquaintance who knows, and also wants to know how/if you're healing:
Intonation: "Hey, how are you? Feeling any better?"
Answer: "Yeah, getting there. No neurological damage, which thank god."

Friend who knows, but is just greeting—like first thing in the morning:
Intonation: "Hey, how are you?"
Answer: "Good! And you?"

Friend who knows, and is inquiring about the status of your health—like a phone call, or over coffee, or a drink:
Intonation: Hey, how are you?
Answer: [HONEST TIME TALK]
posted by functionequalsform at 7:05 AM on September 3, 2014 [5 favorites]


"Getting by."
posted by worldswalker at 7:22 AM on September 3, 2014 [2 favorites]


Another vote for "Hanging in there" as a perfectly acceptable response. "How's it going?"/"It's going." also works if they phrase the question that way.

You could also say something unrelated to your chronic pain, like discussing something you've been doing over the weekend or that you're having a busy day at work. Even if your coworkers are trying to make it about your chronic pain condition for some reason (which I doubt) you don't have to play that game.
posted by capricorn at 7:29 AM on September 3, 2014


Unless you're really sure they really are asking and want to know how you are, you can do what I do...

Them: "Hey, how are you?!"
Me: "Hey, what's going on?!"
Them: "Oh not much. Hey, do you want to go to the blah blah blah..."

Works every time.
posted by the jam at 7:35 AM on September 3, 2014 [8 favorites]


"How are you doing?" is just a greeting. The proper response is "Fine."

"No, really, how are you doing?" as a followup question is a genuine request for information about your current wellbeing.
posted by Jacqueline at 7:38 AM on September 3, 2014 [2 favorites]


I tend to say fine, but I realize it grates on me more when I need to talk/vent about it and I wish I had the sort of friends who would listen. Which is to say, a number of things help me with that frustration-

1- A therapist who can literally just listen to venting if it helps
2- An online or in person support group- blogs, activist communities etc for people coping with chronic pain or similar issues
3- Realizing that I often listen to other people ramble about horrible life problems or pains or chronic illnesses and I tend to not ever say anything about mine which leaves me feeling like "no one cares" when I often don't give people a chance to support me. Suddenly off loading on some random person at work who asked "how are you" is not the best way to change this sort of dynamic if that's the case for you, think through who you have been listening to, and have you ever TRIED venting to them about a bad day? Just send them an email or text, that's light "UGH having a terrible day, sort of feel like venting pathetically, would you be around later to just listen?" I have found a number of people have been awesome at this and they know the favor will go the other way (and has many times) when they need to do the same. I realize that when I went through a period where every day was terrible I just stopped telling even my close friends how I was doing because it was too awful-- that doesn't mean you can't choose moments where you're allowed to vent about everything being awful and make sure you give as well as you get.

I'm sorry you're dealing with this. If you're mainly just asking whether this is an appropriate time to lie and say fine, then yes that's appropriate. It is sort of a weird social convention, like why do we all ask each other how we are when we have no interest in hearing? Why not be more honest and just say "Hello!" and that's it? Strange, and yes sort of a rude convention. It would be nicer if we all actually genuinely cared about each other. But so is life. Nothing wrong with keeping distance from the level of pain some people are in, it's just strange that we bother to fake ask how people are.
posted by xarnop at 7:56 AM on September 3, 2014 [1 favorite]


Are you meaning the dissonance of being in pain and feeling like you're lying with the polite good reply? I use "looking forward to the weekend/next cup of coffee" dodge for that so I'm not lying directly. If it's the invisibility of pain, it is a weird experience and it can be good to have a visual shorthand. I've been in chronic pain for a long time, not realizing until I got actual painkillers and went "oh so this is what it can feel like, if forgotten." And it is weird especially with people I know quite well not to mention it, but also wearisome. I would want to know if a friend collapsed and had a blinding headache for a day, but that's just a regular Tuesday for me, so I calibrate and only mention extreme for me health events.

However I gave in and wore sunglasses while indoors a couple of times and that helped SO much. I had been just powering through or hiding in another room because I felt so silly with shades on indoors, but my meds hadn't kicked in yet and that turned out to help by giving people a visual cue that something was up but manageable, so I got a little bit of space and help but could still participate. I wouldn't wear them at work but in a social setting, I think they might be an easier shorthand than having to explain yes, I'm in pain but functioning.
posted by viggorlijah at 8:03 AM on September 3, 2014 [1 favorite]


Being a thorough pessimist, I can pretty well always imagine things being much, much worse. I am, after all, on my feet and at work. "Not so bad," is truthful. "Hanging in there" and "Can't complain" are okay, but not hugely friendly. "Things are looking up!" (Managed some nourishment today!) "Doing well." (Ruled out two drugs as ineffective so don't have to deal with those sideeffects anymore.) I prefer to be upbeat about my health problems although I don't always succeed.

When "How are you?" is merely a polite greeting rather than a real question, you don't actually have to answer it with details about your health. "Glad to see you!" is another good way to answer the question. I can be glad to see someone and zonked out of my mind on migraine medicine simultaneously. If the person is not someone you want to tell about your ill health, your really don't have to either tell them, or lie about it. Simply move right on. "Ah, you've brought me the financial reports! Thank you! And how are you!" will go over just fine and not leave them with the impression that you are in the pink of health, bragging about it, nor whining all the time.

For serious on going health problems I recommend evading the question if you don't want to be a pollyanna. They will ask again if they want to know personal details. They are not even going to notice if you promptly say something general -"Goodness, what deadful rain!" or "Hang on a sec while I get logged in to the computer," and then follow up with the counter "How are you."
posted by Jane the Brown at 8:08 AM on September 3, 2014 [1 favorite]


"Muddling through." was my response. It was the truth, in my case though it was during a time of more emotion than physical pain, but has a light hearted touch so people didn't feel I was forcing my situation upon them and it still covered the social niceties. I couldn't just answer "fine" because it felt like a betrayal of what I was going through.
posted by wwax at 8:11 AM on September 3, 2014 [2 favorites]


Yes, your current response is pretty much the norm, unless your doctor is asking, obviously.
posted by elizardbits at 8:20 AM on September 3, 2014 [2 favorites]


Do your co-workers know about your condition? If they do, I think it's fine to answer honestly. I think you can do a lot with tone of voice too - when I ask someone how they're doing and they say okay but I can tell they're not that great, I'll say "really?" or "that good?!" or something like that. Then if they want to go a bit further they can, or they can shrug it off. Similarly, I can choose to accept their response at face value if I, I don't know, don't actually care or something.
posted by raspberry-ripple at 8:27 AM on September 3, 2014


How are you?

"Rolling along."
"Getting by."
"Can't complain!"
"Same old, same old ..."
"Oh, just doin' what I do!"
"Happy it's Friday!"
"Can't wait for Friday ..."
"Loving the weather today!"
"Wet -- can you believe this rain?"
"I'm chillin' like Bob Dylan and killin' like penicillin!"

Okay, maybe not that last one.
posted by Eyebrows McGee at 8:37 AM on September 3, 2014 [4 favorites]


"How are you?" to me isn't even a question, it just means "hello." the jam is correct that no response is even necessary. However, something like "oh you know, gettin' on" is fine to say if you don't want to lie that you're tip-top but also don't want to deflect the question.
posted by stoneandstar at 10:00 AM on September 3, 2014


1000x what Jacqueline said. It's just a greeting; don't answer the question but give another greeting in reply:
A: "Hey, how are you?"
B: "Good morning!" "Nice to see you again!"
No lying, subertfuge, extraordinary details, "Debbie-Downer" impressions, etc.
posted by whatzit at 10:01 AM on September 3, 2014 [4 favorites]


I hate the "how are you" greeting. But really, they don't want an honest reply, as others have pointed out. I find "surviving" is a pretty good response.
posted by Eicats at 10:14 AM on September 3, 2014


I'll agree with previous answers who say that most people when they ask "How are you?" don't really want an honest answer, so saying that you're "Fine." and leaving it at that is perfectly okay.

That being said, I generally go with, "Tired. I'm tired." Because I am always. freaking. tired. I've found tired to be an acceptable answer to most people because they can come up with their own reason why I might be tired and go about their business without giving it a second thought. It doesn't break the rhythm of the greeting routine, and I can be truthful about how I feel without raining on someone else's day. Also, if they truly care how I'm feeling, "tired" will generally get the conversation started.
posted by patheral at 11:24 AM on September 3, 2014


Oh, I've also used "Could be better, could be worse." whenever I don't want to use "tired". But I've been tired for a long time (decades), so it's my usually go to response.
posted by patheral at 11:27 AM on September 3, 2014


20+ years experience with chronic pain here. And I take a little bit different tack than most folks above.

I'm great. I'm ALWAYS great. Great is a state of mind. It has no relation to my current state of health, or pain levels, or any of that stuff. I choose to be great, so I am.

I look at it this way: I could be in a lot of pain, and having trouble walking, and can't see straight, and be miserable, or I could be in a lot of pain, and having trouble walking, and can't see straight, and be happy. Either way, I'm still in a lot of pain, and having trouble walking, and can't see straight. So I choose to be happy.

Granted, it's not always easy to pull off. Some days, I do it better than others. But those days when it's a struggle, I look it as practice faking it til I make it. The most negative I'll let my response to "how are you?" become is "Oh, I'm hanging in." But the majority of the time, I'm great!
posted by The Almighty Mommy Goddess at 1:38 PM on September 3, 2014 [5 favorites]


For your coworkers, if this is just said as a greeting I'd keep it light and positive. If you say "Good, and you?", no one expects that to be a literal statement.

Think carefully before you respond to "How are you?" with something that might sound as though you aren't all that happy to be at work, or aren't going to be able to work to your usual standard that day. Your workplace may vary, but for most a reputation as the person who can't wait til Friday is not going to help you at work.

If you need to inform someone of the state of your health, the way to not seem like you are complaining is to not put it in the ritual greeting. "Fine, how are you?" -- after their answer, you can tell someone what they need to know.
posted by yohko at 4:44 PM on September 3, 2014 [1 favorite]


Q: How are you?
A: Tolerably well for an old man in my condition.
posted by Grumpy old geek at 5:07 PM on September 3, 2014 [1 favorite]


I was diagnosed with prostate cancer. I went to see my urologist. It went like this:

Doctor: How are you?
Me: Great!

I was very conscious of the irony at the time.

Meanwhile watch this:

http://allbleedingstops.blogspot.com/2014/06/pain-and-suffering-in-er.html
posted by SemiSalt at 5:34 PM on September 3, 2014


I'm a chronic pain sufferer. I think most of the time "Fine, and you?" is the maximum exchange that is required because "How are you?" usually isn't meant literally and most people do not actually care (which is fine.)

For those times when a friendly and corny platitude is useful, I like the stock answer of a old, local radio talk- show host: "Better than most, not as good as some."

I try to remember that "How are you?" and "How are you feeling?" are usually totally unrelated questions.
posted by Room 641-A at 6:09 PM on September 3, 2014


I think "same as always" is the best answer already.
posted by jenfullmoon at 6:48 PM on September 3, 2014


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