President George W. Bush is hit by a strong case of constipation. He sends his Spanish secretary, who knows little English, to the local hospital. She tells the doctor, "Big President Bush, no s**t."
The doctor understands and gives him some medicine to take with him.
The next day, the secretary comes back again and says, "Big President, no s**t."
The doctor gives him even stronger medicine. A few days later, the secretary comes yet again and says, "Big President, big no s**t."
The doctor gives him the strongest medicine he has.
The next day, the secretary comes back to the doctor and says, "Ba-Boom! Big s**t, no President."