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 shit."
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 shit."

The doctor gives him even stronger medicine. A few days later, the secretary comes yet again and says, "Big President, big no shit."

The doctor gives him the strongest medicine he has.

The next day, the secretary comes back to the doctor and says, "Ba-Boom! Big shit, no President."