“Please don’t ask me how I am/
I have to lie and say I’m fine.”
— The Fastbacks

I couldn’t tell what was causing me more discomfort: the urinary catheter, the nasogastric tube or the numerous IVs dangling from my limbs like strings on a marionette. Then I coughed, and my question was answered — none of the above. I was still writhing in pain from having my guts ripped out a day earlier when I underwent a colectomy, the culmination of my 14-year “partnership” with Crohn’s disease. I looked every bit as awful as I felt, so when the nurse asked me in a cheery, customer service–like voice how I was doing, I wasn’t sure how to respond.

Was she serious? The tone of her voice clearly suggested things were “just peachy,” and it was obvious she expected my reply would reflect that. Did she not see that giant tube hanging out of my nose? Or all the tubes and wires hooked up to my arms and torso?

So what was my reply? I don’t know — which incident are we talking about? After all, this same situation repeated itself almost every time someone entered my room. Most of the time, I’d be brief, sometimes just grunting and making pain sounds. Other times I’d lay it on really thick, actually using the word “peachy.” Though, in moments when I just couldn’t take it anymore, I’d look at the person asking, then down at myself, then back at the person and reply, “Really?”

Having lived with Crohn’s for so long, my hatred of “how are you?” has developed over the years, reaching its peak during the period when I had the worst flares and easing up a bit after that. The worst is when I predict it, when I enter a situation or approach someone I know will ask me the question and make it extra syrup-y. My response depends on how quickly I want to get it over with.

I don’t have a personal grudge against anyone for perpetuating the phony salutation. They mean well, and there really aren’t that many other ways to break the ice between acquaintances. (Close friends, on the other hand, I expect more from.) But they don’t understand how grating it is to hear those words when your average day is filled with the pain, anxiety and various difficulties that come with having Crohn’s disease.

When you have just gone to the bathroom for the fourth time in as many hours and know you’ll be back soon enough, when the pain in your guts is still there hours after you ate, and when you feel like there’s cement in your stomach, how would you respond if someone who is oblivious to your torture and has no idea what it’s like asks how you’re doing, with the understanding that you’re supposed to say, “Oh, just fine”?

It’s the question we’re not supposed to answer, not really. And it’s like we’re being teased, like the person is putting on an air of concern only to say, “Nah, I was just playin’; I don’t really want to know how you’re doing.” Of course, it’s just another part of our “have a nice day” culture — putting a happy face on everything without really wanting to think about it.

What we need is a better choice of salutation, something that doesn’t ask such specific a question. Perhaps the ever-popular “what’s up?” or something more playful like “what’s the word?” Both are vague enough to not warrant a particular answer and thus not get on my nerves. But I know I’m dreaming if I expect people will ever think about this enough to change their ways.

To most people, this all probably sounds silly, if not a bit petty. But to people with Crohn’s or similar conditions, it’s just one more thing adding to and reminding them of their alienation. When you suffer from an “invisible illness,” others assume you’re OK and can do all the things healthy people can. But we can’t, and the activities you take for granted — such as eating or traveling — we can engage in only after carefully weighing the risks. So when I’m asked a seemingly non-question like how I’m doing, you can bet my reply is equally calculated.

Now, with all that being said, today has been a good day, actually. Thanks for asking.