I'm with you. Bush is responding to the printed question. His response is written in cursive: "Is this possible..."
The caption to the Reuters photo reads...."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."
If this is his hand and pencil, then technically, he is writing a note to Condi, just not anything to do with needing a bathroom break.
Granted, I know that's weak, but nothing weaker than a Clinton could come up with.