Scott Legato / Getty Images P.O.S performs during 2012 Lollapalooza at Grant Park on Aug. 4, 2012 in Chicago.

This May, at the Soundset hip-hop festival near Minneapolis, Stefon Alexander—the punk-influenced indie rap emcee who performs as P.O.S.—realized something was very wrong. He played his normal energetic half-hour set for a crowd he estimates held more than 16,000 fans. But, as soon as he got off stage and the adrenaline subsided, he began to feel awful. He collapsed in his trailer, unable to catch his breath, unable to cool off. He had been diagnosed with chronic kidney disease as a teenager and had lived for nearly 15 years knowing that it would catch up with him. That day, at Soundset, he knew that it had.

“I was just destroyed, lying on the ground, thinking to myself that this is getting serious,” he recalls. Soon after, his doctors informed him that he would have to begin dialysis and that his life depended on receiving a kidney transplant in the very near future. Now, a few months later, that operation is on the horizon. It’s not an unusual situation for an individual with kidney disease—and, unfortunately, it’s also not unusual for musicians to lack enough health coverage to pay for emergencies. What is unusual is that P.O.S. has turned directly to his fans for help.

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On Oct. 19, the rapper took to YouTube to inform his fans that he would be postponing a planned nationwide tour in support of his new album We Don’t Even Live Here (which came out Oct. 22), having learned that he would not be able to do dialysis while on the road. “I might reach out to you to help me get a new kidney and heal up, whether that be ‘see if you have a kidney that fits my body’ or if you have 20 bucks to throw at it,” he says in the (NSFW, language-wise) video. Asking fans for a kidney turned out to be unnecessary: through close friends and family, the rapper was able to find potential donors to take place in a donor chain, in which a dozen pairs of donors and recipients have teamed up so that everyone finds a match. The details of the operations should be confirmed next week, he says.

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But even though the kidney is taken care of, the money’s not. Shortly after posting the video, his crew, the Minneapolis-based septet known as Doomtree, created a crowdfunding page via YouCaring.com for fans to offer financial support. Even though he is insured, his insurance only offers minimal coverage designed for those with pre-existing conditions; his dialysis makes him eligible for Medicare too, which should cover the operation, but will leave him worrying about his care and living expenses. That worry is because ticketholders weren’t the only ones dealing with the fallout of the cancelled concerts: Alexander says that, because he doesn’t sell a huge number of records (his 2009 album Never Better hit No. 106 on the Billboard 200), he depends on live concerts to make a living. With the tour canceled, he has no way to pay for the care needed around the operation or for living expenses until he is able to tour again.

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Doomtree’s use of online crowdfunding platforms is an innovative approach to the old tactic of benefit concerts and working with industry-based foundations. “This is nothing new,” says Neil Portnow, President and CEO of The Recording Academy. “This is a significant issue in the music community.” Musicians tend to have unstable incomes and not to think of themselves as small businesses that should insure the single employee. The community has long used nonprofits and DIY benefit concerts to funnel money from fans to artists in need—technology is just cutting out the middle man, the same way it has for artists who use crowdfunding to pay for recording their albums or going on tour. The Recording Academy also operates MusiCares, a foundation that assists musicians in emergencies (and which, says Alexander, gave him the idea that his fans and community might be a good safety net).

Portnow also says that, while seeking community support is not a new thing for musicians, the situation has been exacerbated by changes in the music business. “The creative community is always finding the struggle between art and commerce—particularly in these times where copyright has come under siege,” he says. It’s difficult to make a living from touring, but doing so is becoming less uncommon as record sales drop nationwide and royalties from catalog sales follow suit.

Alexander’s crowdfunding tactic wouldn’t work for everyone. For one thing, Alexander’s request is reasonable, explains Alex Maiolo, a musician who also runs the Health Insurance Navigation Tool at the Future of Music Coalition, an advocacy group for the community. But the out-of-pocket cost of major surgery and surrounding care (the United Network for Organ Sharing estimates an average cost of over $200,000 for a kidney transplant) is often too much to ask of fans. A supplementary amount, like the $25,000 asked by Doomtree for Stefon Alexander, is feasible—and, since ill musicians are unable to work, it’s also something that Maiolo says he believes will always be needed, even if health care reform means that soon enough even musicians will be uniformly insured.

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Alexander says it’s also hard to publicly admit you need help, without the screen of a foundation making sure the request is confidential. But the the support of his fans—who have already helped him surpass his initial fundraising goal by more than $5,000—has balanced out the awkwardness.“I love making music, I love playing shows, I love being in the studio. My whole life is totally different right now. I [have to] go to sleep at 8:00,” he says. “I don’t want to demand anything more than I need. I don’t even want to ask. If you read it you’ll see it’s from our label and I didn’t write any of the copy. It feels pretty terrible to feel like I’m begging. That’s not an awesome feeling, but it is an awesome feeling to have my fans just show up.”

And there’s another reason for him to feel good about the public nature of his request, says Rob Max, executive director of the Sweet Relief Musicians Fund, another organization that helps musicians in need: it helps musicians who don’t have such a devoted following by making listeners aware of the larger healthcare situation in the industry. “For every P.O.S. there are a thousand musicians who have had nowhere near the audience to reach out to,” he says. “I applaud P.O.S. for bringing light to the issue. It’s wonderful that you can give 20 bucks and you know it’s going to save a life.”