River Caroline Sames

River Caroline Sames, age 26 months, of Johnson City, was the beloved daughter of Sara Ecay and William Sames. She surprised her family by being the first girl born after three boys, but just a few hours after she arrived Sara noticed that she was different from her previous children in other ways as well. River was transferred to the NICU, where her parents were given the shocking news that her brain had not formed typically. Through genetic testing, they found she had a very rare genetic disorder called MPPH syndrome, and that she was one of fewer than 100 people ever diagnosed with this disorder. No one could tell them what this would mean for her future, but they soon discovered it meant that she would touch their lives in profound and unexpected ways.

River had to work harder than most, facing global developmental delays and an extensive list of medical challenges, but what she lacked in milestones, she made up for in personality. Her strawberry-blond hair was always the first thing people noticed, but it was her contagious smile and gentle spirit that truly touched the hearts of everyone she met.

No one could get River laughing quite like her three older brothers. She enjoyed all of their boisterous play — the louder and sillier, the better — and her enthusiastic laughter would egg them on in whatever chaos they were creating. She adored her Grammie, who knew all of her favorite songs and games, and she always looked forward to seeing her home nurse, whom she greeted each morning with the biggest smiles that lit up her whole face.

River enjoyed gentle movement, including car rides, stroller rides, rocking, and being in water. She liked listening to music, laughter, and familiar voices. She loved to snuggle, cuddle, and make friends with the nurses during her hospital stays. She even usually enjoyed doing her therapy exercises and her “shaky vest” respiratory treatments. She did not like being hot, having her nose suctioned, or having all the medical tape and stickers removed at the end of her hospital stays. She had a cheeky sense of humor and enjoyed staying up late to watch movies, sneaking tastes of food when no one was looking, holding her breath to scare her nurses, and laughing at the most inopportune moments.

On April 21, 2026, River passed away at Niswonger Children's Hospital from complications of a respiratory infection and pneumonia. After her three brothers said their goodbyes, River passed peacefully in her mother’s arms, with her father by her side, surrounded by the love of all who knew her. Her time on this Earth was far too short, but she touched more lives than anyone could count. She taught us beautiful lessons about joy, acceptance, and love, and although she is gone, the light she brought to this world remains. River girl, we can no longer hold you in our arms, but we will forever hold you in our hearts.

In addition to her parents, River leaves to cherish her memory, her loving brothers, Liam, Luxton, and Leo; her beloved caregiver, Danielle Rice; grandparents Tom and Kathleen Ecay of Johnson City and Bill and Martha Sames of Leakey, TX; uncle Aaron Ecay of England; aunt Hannah Ecay of Wisconsin; great-grandparents Thom and Joan Ecay of New York and Gayle Bannon of Connecticut; as well as many great-aunts, great-uncles, and cousins.

The family would also like to thank Danielle for the extraordinary care she provided to River at home, as well as the many physicians, nurses, therapists, and staff at Niswonger Children's Hospital, Dolly Parton Children's Hospital, Niswonger Children's Therapy Services, Mini Miracles Pediatric Therapy, TEIS, and the Katie Beckett Program for the concern, care, and support River received throughout her 26 months.

A Celebration of Life honoring River Caroline Sames will be held on June 7, 2026, from 1:30 p.m. to 4:00 p.m. at the Hands On! Discovery Center and Gray Fossil Site. Family and friends are invited to gather in remembrance of River and to celebrate the joy, laughter, and love she brought into the world. A meal will be served as loved ones share memories and honor the beautiful impact River made during her time here.

In honor of River’s bright spirit, the family encourages guests to wear casual, colorful attire. A tie-dye station will also be available, and anyone wishing to participate is asked to bring a pre-washed 100% cotton shirt or other cotton item to dye.

In lieu of cut flowers, guests are welcome to bring a live flower, plant, or perennial that can later be planted in River’s memorial garden — a living tribute created in her memory to continue growing with love and color for years to come. For those who prefer, donations may be made in River’s memory to:

PMG Awareness Organization

Brady Wynn Foundation