11. How are you?

I have been asked this so often in recent months that by now, I should be a dab hand at answering.

But How are you? is a hazardous question, both for the inquirer and for me.

This, I have come to realise, is because it has so many different meanings, requiring me to select the correct answer from a range of possibilities. The hazard lies in the risk of a question-answer mismatch.

At one end of extremes, there is Hi, how’r YOU?

This is usually spoken quickly and accompanied by a cheerful smile (if the questioner even looks at you, that is). The average Englishman is an expert at this one. Shopkeepers excel at it. (I’ll give you an example in a minute.)

The correct answer to Hi, how’r YOU? is: I’m fine thanks. Isn’t the weather lovely? But what a shame England is out of the World Cup.

At the other end, there is Hello! How AAAAARE you?

This is usually spoken slowly and with a frowning half-smile that says I know exactly what you’ve gone through, and I’m ready for your long and considered response. Tears are fine, by the way, I’ve got a spare Kleenex.

The correct answer here is: Let me put the kettle on and I’ll tell you all about it. Have you got a spare 45 minutes as well as that spare Kleenex?

In-between, there are all manner of variations, and their meanings are not always easy to discern.

There is How ARE you? spoken fairly deliberately but somewhat nervously, with the questioner not daring to smile. I sense that they fear an honest answer, and they worry that they might not even have enough Kleenex for themselves, let alone for me.

The correct answer in this situation is: I am fine, given the circumstances. And how are YOU?

Then there is How are you (recovering from the surgery? Has your scar healed yet?)

And How are you (coping with the requirements of daily life?)

The trouble is, How are you? is, in England, just a conversation starter. And people no longer dare to just talk to me about the weather.

How are you? is a light-hearted question, so both of you can clear your throat and test your voice before moving on to the real conversation, which can range from That’s £12.99 please to Have you heard so-and-so is getting married?

But now, everyone knows that the standard I’m fine thanks is not going to work when they ask me the question, even if they do the quick-with-a-smile version. My blog, which seems to be read even by people I don’t usually stop to chat to, has helped to ensure that everyone knows I am definitely not fine right now.

Some people dare to acknowledge this, asking the question with an apologetic smile that says: Well, I’m asking, but I know the answer. Sorry.

The complication is this: very often, I actually DO feel fine.

I know I am not well, I am exhausted and my arm hurts when I lift it and my chest feels tight and bloated and I miss my mother – but I also know that I am fundamentally OK. There are many moments in the day when I feel genuinely happy. Blessed, even. Savouring the luxury of a morning spent in silence, getting up slowly, having breakfast slowly, sitting down for my daily meditation and breathing slowly, taking my time over everything. The sun is shining. I am not worrying about a lack of meals (which have been appearing on my doorstep, freezer-bag shaped, like a miracle) or a lack of love. Most of the time, I feel that cancer affects only my outside, not my inside.

There are some people close to me who know and understand this. These are the people who can genuinely ask How are you? and I can simply answer I’m fine, or I’m not fine, and they know that it is true. (They also know that the answer could flip within minutes.)

But that kind of understanding only comes from intimate friendship or kinship, and of course most people cannot fall into that category. It would be utterly exhausting to have more than a handful of such intimate relationships, as well as utterly undesirable, because it would leave me without my edges and boundaries. I would lose myself.

So you, my friend, are left with hazarding How are you? and hoping that my answer matches both your mood and mine. By all means, don’t stop asking. It’s the lubricant of British communication.

It is the people who stop asking or saying anything, fearing their own words or mine, that upset me more than any unfortunate question.

But I cannot promise a perfectly matched answer.

There have been many times when I knew that someone was ready to hear the 45 minute response, and I knew that they would have been an excellent listener, but actually, I wanted a bit of a break from Talking About Life. So what they got was I’m fine. That’s a lovely dress you’re wearing, by the way.

The opposite has also happened, however hard I have tried to prevent it.

There was the woman at the till at Gatwick Airport, for example. I was there for the second time within a week. I was on my way to my dying mother. I should have had my mastectomy a few days earlier, but I had quite literally pushed the cancer problem aside.

I could feel my skin prickle with tears trying to find a way out: that bizarre feeling that everything around me was so very clearly outlined but I was not part of it. (I really wasn’t. It was bustling with excited and scantily dressed holiday makers.) I thought I’d abate my restlessness by the useful activity of buying a pair of clip-on sunglasses that I needed for the car.

Hellooo!! How are you FEEEELING today? The till woman smiled broadly as she scanned my purchase, using an “isn’t this a very jolly place to be” kind of voice.

I tried. Honestly, I did. I’ve lived in Britain for three decades; I know the drill. I tried to put on that smile and drag up the required I’m very well, thank you. But what I heard myself say was a mumbled and glum Hmrhrgr… you DON’T want to know...

Undeterred, the till woman breezed: Going anywhere nice on holiday?

I battled on. Eehhh… no, not really…. (Please, I thought, please take the hint, or you are in actual danger of being told my life story, and that would interfere with your enjoyment of lunch).

I thought I’d escaped, until she called loudly to my retreating back: Well, have a WONDERFULtime! I hope you REALLY enjoy it!

It shattered my defences. I cried all the way to the gate. At least I now had a pair of sunglasses to hide my distress. Perhaps it was these summery sunglasses that had been misleading. Next time I can’t cope with How are you? at the till, I’ll make sure I throw in a box of paracematol.