I mean, think about it:
Boss: How are you?
You: Miserable. I hate my job, and I hate you too.
Mother: How are you?
You: Fucked in the head, and it's all your fault!!
Doctor: How are you?
You: I feel like shit. Why else would I be here, you idiot? How did you get through med school, Einstein?
So now that I've given you all eeevil ideas:
So, really, how are you? Be honest.