In the center of the scene, let's place a large, festively decorated cake with the number "40" prominently displayed on top in sparkling, glittery candles. The cake itself is multi-tiered with pastel colors and intricate, whimsical designs that would make it look right at home in a Disney film. Surrounding the cake are various colorful balloons, each one with a different cheerful pattern like polka dots, stripes, and stars.

To the left of the cake, we have a blond nurse in a charming cartoon style, reminiscent of Charles Schulz's Peanuts characters but with a modern twist. She’s wearing a traditional white nurse’s uniform with a bright red cross on the hat and a stethoscope slung casually around her neck. Her face is lit up with a warm, welcoming smile, and she’s holding one of the balloons by its string.

To add a sense of fun and adventure, let's include a scene where the balloons are forming into the shape of Lindsay's name. The balloons stretch high into the sky, each letter composed of a cluster of smaller balloons tightly packed together. The letters are big and bouncy, floating effortlessly in the air.

Behind this central scene, there's a backdrop that features a whimsical, cartoon-style hospital with a red cross on top, inspired by the architectural style you’d see in Hergé’s Tintin. The hospital is surrounded by a beautifully manicured garden with flowers that have a slight glittery sheen to them, catching the light just perfectly.

In the foreground, there’s a banner strung between two trees that says "Happy 40th Birthday, Lindsay!" in bold, glittery letters. The trees have a soft, inviting look, like something you’d see in Winsor McCay’s Little Nemo in Slumberland, with lush, overhanging branches and sparkling leaves.

On the ground around the cake and nurse, scattered stethoscopes lay in various playful poses as if they were thrown in celebration, and confetti shaped like tiny medical symbols (hearts, syringes, and pill bottles) is strewn about.

Each element is meticulously detailed, with vivid colors and a playful, celebratory atmosphere, making it the perfect birthday greeting card for Lindsay.

Generated with these themes: 40th birthday, Balloons, Stethoscope , Glitter , and Blond nurse .

Made with ❤️ by AI.