I think this gets exactly to it, but I don’t agree with the rest of your comment.
In both the provided examples, the fact that there's a request for actionable information is already implicitly understood based on the situation. When a doctor comes into your room, you already know they're checking on your condition. The "How are you?" is just general greeting (to which, in casual situations, the proper response is "Fine, and you?").
And this is the crux of the misunderstanding. The Russian takes it as a request for information when it isn't.
I think the doctor was asking, relative to the situation that you're in, how are you? In other words, given that you're in this shitty situation, do you feel worse or better than you expect?
If he's still in a lot of pain then the doctor would expect the patient to say that. "The nurses are treating me well, the food is fine, but I'm still in a lot of pain. Is there anything you can do about that?"
The doctor was asking a question relative to the situation and the Russian interpreted as an absolute question.
I think this gets exactly to it, but I don’t agree with the rest of your comment.
In both the provided examples, the fact that there's a request for actionable information is already implicitly understood based on the situation. When a doctor comes into your room, you already know they're checking on your condition. The "How are you?" is just general greeting (to which, in casual situations, the proper response is "Fine, and you?").
And this is the crux of the misunderstanding. The Russian takes it as a request for information when it isn't.
*Edit*: A YouTube video pulled from another comment in this thread that explains what I was trying to say much better: https://m.youtube.com/watch?v=eGnH0KAXhCw&feature=youtu.be