I'm pretty sure that the correct answer is d. meaningful and enjoyable interactions that are important.
In the context of an adjective used to describe pain, we can look at the answer choices:
Silent pain seems like an odd choice for someone to notify a doctor about, so that is probably not the answer.
Thoughtful does not describe pain.
Responsive does not describe pain.
Severe pain would be a reason for someone to notify a doctor, so this is likely the correct answer choice.
The one i would choose is A. Becuase the actions of them did cause his death.
