IT WAS DECEMBER 12, 2012, AND THE
teenager played cards with his mother
at their home in Clayton, North Carolina.
His girlfriend spent Wednesdays with
her family, and card games had become
a weekly tradition for the Teems. They
settled down to a session of Phase 10.
Hogan beat his mother, closing the
gap in their running rivalry to 13-11. At
9.30pm he went to bed; the following day
was a busy day of high school, ending
with baseball practice. There was no
indication that it would be his last.
Hogan was physically fit, spending
long summer days mowing lawns in
the North Carolina heat. He played
American football, basketball, baseball
and golf. He loved swimming, hiking and
fishing. He went on mission trips with
his church. He never suffered illness or
missed a day of school. To all intents and
purposes, he was a healthy 17-year-old.
Baseball practice on December 13
was business as usual. Participating
in light conditioning work, Hogan took
it easy so as not to strain his ankle,
which he had sprained a couple of
weeks earlier. Then he approached
one of his coaches midway through
practice, saying: “I don’t feel right.”
Before the coach could respond, Hogan
blacked out and fell to the ground. The
training staff administered CPR, and an
ambulance was on the scene almost
instantly. The paramedics discerned
a faint heartbeat. Hogan’s parents,
Allyson and David Teem, arrived, and
Allyson travelled in the ambulance. On
the way to the hospital, paramedicslost Hogan’s heartbeat. After several
minutes at the roadside they recovered
it and sped on to the emergency room.
In an effort to keep her son awake,
Allyson taunted him about the card
game. “I was yelling, ‘You cheated! You
owe me a card game,’” she says. “Then
I said, ‘OK, you won fair and square,
but it’s still 13-11!’” Despite Allyson’s
efforts to rouse her son, Hogan was
unresponsive by the time they arrived
at the hospital. Medical staff worked
on him but, after 45 minutes, admitted
there was nothing more they could do.
Hogan had suffered an acute cardiac
event, brought on by a rare and previ-
ously undiagnosed genetic condition
known as an arrhythmogenic right
ventricular cardiomyopathy, or ARVC.
There had been no reason to suspect
that Hogan was at risk, and doctors
don’t commonly run tests for ARVC.
The tragedy was unforeseeable.HOGAN HAD BEEN ADOPTED WHEN
he was five weeks old. Seventeen years
later, his biological parents were raising
three children of their own – two sons
and a daughter, all full siblings to Hogan.
Allyson regularly sent the family letters
and pictures of Hogan via the adoption
agency. After Hogan’s death, she wrote
to his biological parents, urging them
to get the family checked out.
Due to bureaucratic procedures, it
took nine months to get the message
through. The two boys, their sister and
parents underwent cardiac imaging.
The results came back normal, and the
family breathed a collective sigh of relief.
Then, four years later, the youngest
sibling, Ethan White – then 14 –
complained of chest pains while playing
basketball. He called his mother, who
arrived to find him grey and clammy,
complaining of pain in his jaw and
arm – heart attack symptoms. His
mother rushed him to hospital wherehis heart rate was found to be 263
beats per minute – the average heart
rate fluctuates at 60-100bpm. Ethan’s
condition worsened, but as doctors were
preparing to carry out defibrillation, he
vomited and his heart rate fell.
As his condition stabilised, Ethan
was transferred to Duke University
Hospital, the major medical centre in
that part of North Carolina, where he
was monitored and fitted with an inbuilt
defibrillator. It was clear to staff that
Ethan had experienced an acute cardiac
event consistent with ARVC – and that
another episode was likely. The defibril-
lator was designed to restart his heart
in the event of a further attack. An MRI
scan of his brother, Austin, confirmed
he also had ARVC. The brothers had
the same genetic problem as Hogan,
despite all the tests finding nothing to
indicate a genetic cause. Yet how else
could three brothers raised in different
families, in different parts of the state,
develop the same condition?
With local medical staff stumped,
Ethan and Austin were referred to the
Undiagnosed Diseases Network (UDN),
a group of 12 clinical research hubs set
up to delve into chronic illnesses that
have previously been undiagnosed,
mis diagnosed or simply written off
as psychosomatic. Bringing together
experts in neurology, immunology,
cardiology, endocrinology, genetics,
rheumatology and other domains of
medicine, the UDN was custom-built to
delve into just such a medical mystery.THE
EVENING
BEFORE
HE
DIED,
HOGAN
TEEM
STAYED
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