How do you know when your nurse has also become a friend?
Clay Carter realized it during one of his many visits to Madison Hospital over the past two years while awaiting organ transplant surgery.
“I got to where I actually enjoyed going to the hospital because everyone there was so nice and encouraging,” says Clay, a former NASA web content producer who was diagnosed with end-stage liver disease at age 42.
Liver failure can cause fluid to accumulate in the abdominal cavity, leading to painful swelling, itchy skin, fatigue and more.
Clay depended on Madison Hospital radiologists and Imaging Department staff to periodically drain this excess fluid by carefully inserting a sterile needle into his belly – a procedure known as paracentesis.
At first, he needed it done once a month. But as the liver disease progressed, the fluid buildup worsened. From his initial diagnosis on May 5, 2023, until his organ transplant surgery at UAB Hospital in Birmingham on July 5, 2025, Clay visited Madison Hospital a whopping 111 times.
Each paracentesis treatment would siphon an alarming amount of fluid – up to three gallons – from his swollen abdomen.
Getting the fluid drained “was an unbelievable feeling of relief,” Clay says. “I was like a new person for a few days afterward.”
Not surprisingly, Clay grew close to the caregivers who performed the life-sustaining paracentesis treatments – especially ultrasound technologist Twylia Pickard, registered nurse Michelle Zirbel, and radiologist Dr. Douglas Wester.
“I was in and out of the hospital so much,” he says, “that the employees there became my social life. I came to see them as part of my family, and still do.”
On July 3 of this year, while at Madison Hospital for yet another paracentesis treatment, Clay got a call from UAB Hospital. They had an organ donor with a healthy liver and kidney; he needed to come to Birmingham right away.
Clay’s wife Juli called the Madison Hospital Imaging team with an update as soon as she learned he had survived the difficult, 12-hour transplant surgery.
“They’re our friends,” Juli said, “and I knew they would want to know that he was out of surgery and doing OK.”
Today, Clay is back home in Madison and feeling healthier than he has in years. His new liver and kidney are functioning normally, and he’s getting stronger by the day with help from a team of physical, occupational and speech therapists and home health nurses.
Clay’s immediate focus is just enjoying family time with Juli and the couple’s teenage daughter, Avery. Eventually, he hopes to resume his career.
“What Madison Hospital did for me was lifesaving and life-changing,” says Clay, who will celebrate his 45th birthday in December.
“I wouldn’t be here without their amazing care, enthusiasm and positivity.”