Comment by rconti
5 years ago
It's not fake to smile at someone you do not know and ask how they are. It's merely a greeting.
All cultures have context clues. Your surgeon might have just met you, but be legitimately concerned about your condition. Your best friend might be interested in your emotional state. The stranger on the street might merely be "polite", or hoping/wishing you are having a good day, but neither wanting to hear a full dissertation on your emotional state, nor a recitation of your medical history that a doctor might find relevant.
I am American. I have transitioned from saying "How are ya?" as a greeting to "Good [day,morning,evening]" etc. It's every bit as polite and does not feign concern.