2020 Rare Disease Champion Team: Learn more about Austin Peay defensive lineman Josephus Smith’s rare courage and commitment

Josephus Smith

University: Austin Peay State University

Vitals: 5-9, 285 pounds, senior, defensive tackle

Quick Hits: Josephus had a breakout 2019 in his second season with APSU after transferring from Miles College in Alabama. The three-time member of the Athletic Director’s Honor Roll earned first-team All-Ohio Valley Conference honors after posting 18.5 tackles for a loss. He at least assisted on one tackle for a loss in nine of the 15 games that season. Josephus was a big part of APSU winning its first Ohio Valley Conference title since 1977 and the Governors went on to play in three FCS playoff contests with Josephus registering five postseason tackles. APSU played only three games in 2020 before COVID-19 issues scuttled the season. Josephus picked up right where he left off, registering seven tackles, one sack, one tackle for a loss and a forced fumble in only two games. Josephus and his wife, Shermiria, welcomed their second daughter to the world in May of 2020 at the height of the pandemic. Madison was born premature with Congenital Diaphragmatic Hernia (CDH), a rare abnormality that happens to 1 in 2500 babies. The struggles and battles the Smith family has endured during their journey to save the life of their child, trying to stave off a deadly rare condition is what every parent would do. For Josephus and Shermiria to continue their educations and his football career has been a challenge unlike any other.


Coming off his best season as a college player in 2019, Josephus Smith was firing on all cylinders. The bulky defensive tackle was fulfilling his dream of playing Division I football when so many told him he couldn’t because of his size. He married his high school sweetheart, Shermiria, and the Smith’s were on the cusp of welcoming their second daughter into the world in 2020.

The road to becoming a first-team All-Ohio Valley Conference selection, Athletic Director’s Honor Roll student, loving husband to Shermiria and proud father was full of hard times and tough decisions.

Little did the Smith’s know that football, college degrees and even the near future were about to take a back seat. Those tough times and difficult decisions they already endured were about to serve them well.

In February, when the Smith’s were about to find out the gender of their second child, they were told unborn daughter Madison had Congenital Diaphragmatic Hernia (CDH), a rare abnormality that happens to 1 in 2,500 babies.

CDH is a condition present before birth characterized by abnormal development of the diaphragm. The severity of CDH may range from a thinned area in part of the diaphragm, to its complete absence. CDH may allow the stomach and intestines to move through an opening (hernia) into the chest cavity, crowding the heart and lungs. This can then lead to underdevelopment of the lungs, which may cause life-threatening complications.

The Smith’s immediately started doing research on the rare disease to find out the best information and resources available for them to make the best decisions possible for Madison.

Already facing a 50 percent chance of survival before being born, Madison’s odds became even longer when at 29 weeks Shermiria developed severe preeclampsia. The best solution for Shermiria was to deliver Madison as soon as possible.

At 29 weeks, though, for a baby with CDH, Madison would be too small to go on Extracorporeal Membrane Oxygenation (ECMO), which would greatly increase her chance of living.

The Smith’s found a CDH Facebook group and learned more about a doctor in St. Petersburg, Florida who was having a 95 percent success rate with CDH babies.

They prayed, talked to family and friends and decided heading to Florida to seek out Dr. David Kay would give their daughter the best chance for survival. In the middle of the pandemic, with Shermiria suffering from severe preeclampsia, the Smith’s risked everything. Football career, college degrees, a mountain of medical bills – none of it mattered to Josephus.

His wife, daughter and family came first and that was priority No. 1. He would sort out the details of everything else later. 

Ten days after arriving in Florida, Madison was born on May 20th at nearly 33 weeks. Six days later she had her first surgery and remained hospitalized until late July.

The fight will continue for Madison. Children born with CDH can have issues into infancy. 

Bills have piled up at home and in Florida. Josephus and Shermiria are two college students with a family trying to make it work on a limited budget. To give Madison a fighting chance they had to take on the debt.

Their situation is unique and inspiring. The NCAA has approved a fundraising campaign to support the Smith family that in no way impacts Josephus’ eligibility. Click here to support the Smith family. 


“It was tough having to be in Florida, seeing Madison struggle with tubes in her and crying. We couldn’t pick her up or comfort her. It was pretty tough as parents seeing her going through that. It’s been tough because you don’t really know what’s next.” – Josephus Smith

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