Waitress: What can I get for you?
Me: I'll have a steak.
Waitress: How would you like it?
Me: Immediately!
Waitress: What can I get for you?
Me: I'll have a steak.
Waitress: How would you like it?
Me: Immediately!
Listen up, buttercup. The joke here is that the dude wants his steak right freaking now. Usually, when a waitress asks how you want your steak, she's asking about how well-done you want it. This guy is so dumb, he plays on the double meaning of "how" to mean "when".