[The pain that laces his voice is obvious to him, even without those expressions, and s-sob please stop being so upset because of him 8(]
Are you... someone important to me? [That would explain the familiarity, his reactions to your pain... but the thought that he could have simply forgotten someone who means a lot to him (and to whom he would mean just as much, evidently) is terrifying. He tries to force himself, to think of whether he has seen this person or not, whether he has any recollection of him at all-- but as soon as he does that, the splitting headache from before is back and he's doubling over, clutching his head in pain.]