If this photo weren't from Reuters, I'd be saying "Photoshopped!"

U.S. President George W. Bush writes a note to Secretary of State Condoleezza Rice during a Security Council meeting: "I think I MAY NEED A BATHroom break?"

Or, jwz put it, Bush asks Condoleezza for permission to go potty.

(Semagic's spellchecker wants to replace 'W.' with Ow - George Ow Bush.)