In panel 2, Jim looks like he's being suffocated by the giant talk balloon containing all his ailments that he supposedly never talks about.
In panel 3, Iris appears when her name is invoked, and looks like she's holding up the picture on the wall over the mantle.
Then in panel 4, Jim is totally busted, while Elly doesn't even have the smug, closed-eyes smile, because she has no eyes at all.
Now, how does that work? We've been shown (several years ago) that Jim doesn't appreciate Iris infantilizing him. So why does he gripe to her? Maybe he's just in that old-person stage where he has no ability to self-censor.