is he sighing too heavy? is he furthering himself from you? does he seem like he's lost in thought? do you think he's numb? do you think he's in pain?
you say "notice the signs" and all the signs are right here. so, why aren't you noticing them? i thought you would notice this time. after all, you've seen them so many times but you didn't notice them before, so, why would you suddenly notice now?