Yes, this picture is real. From Reuters.
Here’s the caption:
Wed Oct 15, 11:15 PM ET
US Republican presidential nominee Senator John McCain (R-AZ) reacts to almost heading the wrong way off the stage after shaking hands with Democratic presidential nominee Senator Barack Obama (D-IL) at the conclusion of the final presidential debate at Hofstra University in Hempstead, New York, October 15, 2008. REUTERS/Jim Bourg (UNITED STATES) US PRESIDENTIAL ELECTION CAMPAIGN 2008