can't contain himself

U.S. President George W. Bush writes a note to Secretary of State Condoleezza Rice during a Security Council meeting at the 2005 World Summit and 60th General Assembly of the United Nations in New York September 14, 2005. World leaders are exploring ways to revitalize the United Nations at a summit on Wednesday but their blueprint falls short of Secretary-General Kofi Annan's vision of freedom from want, persecution and war. REUTERS/Rick Wilking

I had assumed that this photo was a fake but then I came across it in this Yahoo News slideshow. This can't possibly be real--can it?

[On edit: Reuters confirms that the photo is legit.]