The alarm will go off, and Earnest Smith will be off to the doctor’s office. 

Five hours of dialysis. Five hours of having two needles stuck into his arm – one to take the blood out, the other to put it back after a machine removes excess waste, salt and extra water.

Five hours in a chair. Five hours of this, three days a week. 

And this morning, after Smith’s doctor’s appointment, he’ll hop back into his car and drive the highways four or five hours from his home on the Kentucky border near Louisville to Fort Wayne, where he’ll ultimately end up at Embassy Theatre.

That’s where the United Dialysis Foundation is putting on a comedy show especially for those who are going through what Smith is going through – living with kidney failure always looming – day in and day out. 

Only for Smith, the Laugh Out Your Pain Comedy Tour tonight takes on a little extra special meaning in that Austin Rich, an up-and-coming comic Smith manages, will be taking the stage with Michael Blackson, Red Grant and Luenell. 

“It’s like going to the big game, it’s like the Super Bowl,” Smith said.

The road back to managing has been a long one for Smith, as all roads in his life have been as of late, and it all began with a decision he made in nearly the blink of an eye when he was about 18 or 19 years old in 1991. 

He was living in Maryland at the time and made a trek back to his hometown of Marion to see his family. When he got there, though, the house was empty.  

“Everybody was gone, and I found out they were all up in Michigan, taking a test to see if they could give my uncle a kidney,” Smith said.

Smith’s uncle, his mother’s youngest brother, was in need of a kidney. Smith drove up to Michigan and decided to go ahead and take the test to see whether he was a match for his uncle. He did so without giving it a second thought.

“I was the only one in my family who qualified,” he said. 

It didn’t take much for him to give his kidney over to his uncle. While he sat in a hospital room, his uncle came in and told him: “Man, I really need this. I’m not ready to die.”

“That conversation, and the fact my mom wasn’t doing it was enough for me,” Smith said. 

He would never change what he did for his uncle. The kidney donation did come with unforeseen consequences. 

Smith said he had never gotten sick in his life, and all of a sudden found himself getting sick regularly. He was on a path where he managed comics and musical acts and was starting a record label. As a result, he kept what he calls “club hours,” which meant late nights and energy drinks. 

“I was doing all kinds of stuff that’s probably not good for someone with one kidney,” Smith says. 

He became a diabetic, and things came to a head after a motorcycle crash in 2010 that landed him in the hospital.

A doctor came into his room in tears, reading blood results to him where his kidney’s functioning had dropped from 60 percent to 20 percent in four months. 

“She told me, ‘It’s pretty much over,’” Smith recalls. 

Today, he calls himself blessed. 

He didn’t die. And though his kidney has continued to degrade – he says it functions at 2 percent now – he is living, even when living is tough.

“Mentally it affects you,” he said. “You wake up some days and you don’t want to get stuck no more. You think, ‘I can’t take it.’” 

But Smith does take it, for the moments with his fiancée, his kids and for seeing the acts he’s again helping on a career trajectory in the entertainment business. And without regrets – even the decision he made in a hospital room nearly 25 years ago. 

“No,” he says when asked whether he’d change it. “No. No. Nope.”

“Not at all.” 

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