
“How are you doing” has a script attached, and the script is why you never hear the truth.
“How are you doing?” is a kind question and a useless one. It arrives with a script attached. The script says good, busy, you know how it is, and both people move on. Nobody lied. Nothing was learned.
“Let me know if you need anything” is worse, because it hands the work to the person with the least capacity to do it. The people who most need to raise a hand are exactly the people who will not, since raising it costs standing they spent years building.