Kyle McCarty's photo album looks different from other children's: One picture shows him riding in a red wagon down a hospital corridor. In another, he drapes a stethoscope around his neck. A third shows him sporting a dinosaur Halloween costume, in the company of nurses.
The newest snapshots to be added were of the 3-year-old kissing staffers at Cardinal Glennon Children's Medical Center and waving goodbye Thursday, when he left after more than two years of living at the St. Louis hospital. He will set out for new adventures like visiting the zoo, playing in a park and dipping his feet in a wading pool for the first time.
Kyle's mother packed up the giggling Elmo doll he received as a farewell gift from those who had become something of a second family: nurses who rocked him to sleep, hospital staff who played games and doctors who let him tag along on rounds.
"There's probably not a person in this hospital who doesn't know him. We're pretty attached," said nurse Andrea Balf. "I think it's good that he's leaving, but it'll be weird coming to work without Kyle."
Kyle was diagnosed with polycystic kidney disease as an infant, a genetic condition where cysts grew in his enlarged kidneys. Both kidneys were removed by the time he was 3 months old, after which he required dialysis and constant care. He got to go home for about half a year when he was 7 months old until infections brought him back to the hospital.
But he had a successful kidney transplant this April, and doctors said he made so much progress he could go home with his family.
Kyle's family lives in Jefferson City in central Missouri, about a two-hour drive from the hospital where he has spent more than two years. His parents, Brian McCarty and Tobey Miller, visited frequently, but couldn't be there all the time.
Both parents have other children and needed to continue working. Miller, 32, estimated the family's out-of-pocket costs for her son's care at about $5,000, noting Medicare and Medicaid have covered the vast majority of Kyle's bills.
Miller, who is studying to become a registered nurse, tried to stay overnight at the hospital when Kyle was sickest. She brought books and blankets for him to make his room feel more like home.
"I try to give him a really good bath, from his head down to his toes," Miller said of her visits. On his good days, she'd take him to the parking lot to pick flowers from the hospital garden.
Hospital staff monitored his health, but also worked to help him overcome developmental delays and provide fun — making art projects, playing games, celebrating birthdays and holidays.
Doctors knew a kidney transplant would work best if Kyle weighed at least 22 pounds, but abnormal metabolic processes and the boy's need to be fed formula through a tube surgically attached to his stomach made it difficult to get him to that size. He also suffered from severely high blood pressure. Altogether, doctors said, Kyle had needed to stay at the hospital to survive.
"He doesn't really know the outside world yet," said Dr. Richard Feldenberg, one of Kyle's pediatric nephrologists.
The boy will initially stay with his mother at the Ronald McDonald House in St. Louis, likely for a few weeks, as he makes the transition from hospital to home. And despite his kisses and goodbye waves, Kyle will need frequent hospital visits for at least several weeks.
Cardinal Glennon staff will miss Kyle, but Feldenberg noted: "I'll see him Monday."