Some radio stations went so far as to report his death prematurely.
Eager to deny the speculation, Mr. Atta Mills jogged at the airport upon his return in a display of his vigor. The following month, though, the 68-year-old was dead.
Many lined up in the capital, Accra, where his body was laid in a casket draped in the national colors of red, yellow and green, to pay their respects Wednesday before his burial Friday.
In a part of the world where presidents traditionally have ruled for life, Mr. Atta Mills was only the latest West African leader to show that “routine checkup” can be code for much graver troubles.
Many longtime rulers in the region have feared encouraging coups or power grabs if they were perceived as vulnerable. Even in a mature democracy like Ghana, those around Mr. Atta Mills tried to protect his image of strength until the very end.
“I think it’s a little bit about power — when you taste it and you really don’t want to give it up whether you’re sick or healthy,” says Kwame Tufour, 36, who owns an energy company in Ghana. “I think it kind of got to his head.”
Political calculation certainly plays a part in an election year, as there can be repercussions if a party’s standard-bearer is seen as weak, said J. Peter Pham, director of the Africa program at the Washington-based Atlantic Council.
While Ghana is an exception as a stable democracy, Mr. Pham said earlier strongmen in the region tended to concentrate power in their own hands until their deaths.
“You didn’t vote for a party with a platform if you voted at all,” he said. “Leadership was viewed and functioned as the figure that you followed.”
Speculation on leaders’ health isn’t unique to West Africa: 88-year-old Zimbabwean President Robert Mugabe insists he’s “fit as a fiddle” despite reports he’s battling prostate cancer.
Few regions, though, can cite as many examples.
Only hours before the death of Gabon’s President Omar Bongo — at one time the world’s longest-serving president — his prime minister described him as “alive and well.”
And Nigeria’s late President Umaru Yar’Adua grew so weak while in office he once had to be carried off a runway by a soldier during a state visit to Togo, according to a book by his former spokesman.
The military officer assigned to Yar’Adua apparently draped traditional robes over his arm to conceal what was happening. State-run television was told to film only one side of his face when the other side was swollen, according to the book by Olusegun Adeniyi.