It was confusing at first because I couldn't see the point of it. It felt like a detour in the story that didn't really go anywhere. I understood the hallucinations probably meant something but I couldn't make any sense of them. I also couldn't understand why Eli seemed to act so differently here than he did in the rest of the novel.
Then it finally hit me. What makes this scene different from the ones where Jocke and Virginia are attacked is that it's told entirely from Eli's point of view. We not only see everything through his eyes but also get a sense of what he feels when he kills someone. That part turns out to be a little disturbing because he doesn't seem to feel anything.
JAL goes into great detail describing every little thing but never gives the old woman a name. That's because it doesn't matter to Eli. He may not like having to kill people but it no longer bothers him, and I think that realization is what this scene is really about. Being with Oskar has reawakened a lot of feelings and memories he probably forgot he still had. The morphine just brings them all to the surface and forces him to confront them.The woman wasn't screaming anymore, just lay still on her back while the blood pumped out of her in weaker and weaker spurts, streaming down behind the sofa cushions. Her eyes were damp and remote as she met Eli's gaze and said, "please . . . please . . ."
Eli held back her impulse to be sick, leaned forward over the woman.
"Excuse me?"
"Please . . ."
"Yes, what is it you want?"
". . . please . . . please."
After a while the woman's eyes changed, stiffened. Became unseeing. Eli closed them. They opened again. Eli took the blanket from the floor and covered her face with it, sat up straight in the couch.
The penguins walking with their eggs become the parents taking their children to the castle, and the mirrored skyscrapers become actual mirrors. When he sees the wig man on the screen he knows he's really looking at himself. Eli rejects being called a vampire because he wants to believe he's different, but deep down he realizes he's becoming as "cynical and hollow" as the others.
This is a big turning point in Eli's life and he's not the same character afterwards. When he burns the house down, he's also getting rid of his old life and starting a new one with Oskar. Without this strange little scene, we wouldn't have an Oskar and Eli.
There! It took me five years but I finally made it to 100 posts.
Thanks for sharing your insights.You should post more if you can. 
