Panel 1: We start out with Elly asking someone on the phone to please hold because she's telling Mister Piranha to be seated because John will be with him in a minute.
Panel 2: A little while later, she asks to speak with someone in Accounting; upon being that no one is available right now, she asks to have the person return her call for Doctor Patterson.
Panel 3: Later still, she tells a patient on the phone to please come back at 2:00 tomorrow while asking Mrs Cleanairsystems to sign a form.
Panel 4: John, who's holding an X-ray, asks a bleary-eyed Elly if she'd like a break; having been driven to the point of exhaustion by the simple tasks we've seen here, she thought-bubbles "Please" like he's a big idiot.
Summary: This foreshadows her selling off Lilliputs because the oh-so-ordinary demands on her time were too excruciating to bear.