A 32-year-old former U.S. Marine held in Russian custody for more than four years was near death before diplomatic pressure finally secured his release, and advocates say at least 10 other Americans remain detained in Russia alone.

Robert Gilman, a teacher from Massachusetts, arrived at Brooke Army Medical Center in San Antonio this week after spending 1,666 days in Russian detention. His advocate told CBS News on Thursday that Gilman was in catastrophic physical condition before Russia agreed to let him go, and that his recovery will be long and uncertain.

Kieran Ramsey, chief investigative officer for the advocacy organization Global Reach, described the grim calculus behind the timing of the release:

"We had to wait 'til almost we were on death's door with him to be able to spur the right kind of action that got his release. And we're just thankful he's back on U.S. soil right now."

That an American veteran had to deteriorate to the brink of death before a foreign government would release him tells you everything about the leverage Russia was willing to exploit, and the cost of delayed action.

Forty-seven days in a dissociative stupor, handcuffed to a hospital bed

Eric Lebson, Global Reach's chief strategy officer, outlined the severity of Gilman's condition before the release. Gilman had been held at a Russian hospital in what Lebson described as a "dissociative stupor", a near-catatonic state in which he was unresponsive and unable to feed himself. He was kept alive through a tube fed through his nose into his stomach. AP News reported that Gilman spent 47 days in that condition, handcuffed to a hospital bed in a psychiatric ward, with his state described as "dire and life-threatening."

Lebson did not hold back about how Gilman's case compared to others.

"The situation with Robert is far beyond anything we have seen with any other American detained in Russia."

Lebson also alleged that Russian authorities subjected Gilman to treatment that included harassment, forced exercise sessions lasting up to 16 hours, and the administration of psychotropic drugs. He further claimed Gilman was pressured to fight in Ukraine. CBS News noted these allegations have not been independently verified. Russian authorities have not publicly responded to the claims.

Breitbart reported that approximately 50 days before his release, Gilman was also diagnosed with severe pneumonia on top of his dissociative state, compounding what was already a medical emergency.

Trump spoke directly with Putin; Russia asked for nothing in return

A State Department spokesperson told CBS News that the Trump administration raised Gilman's case with the Russian government repeatedly and requested his release on humanitarian grounds, citing his deteriorating health. The administration had already secured the release of several other Americans held in Russia, though the specific individuals were not named.

The administration's effort to free Americans detained by hostile governments has become one of its most consequential diplomatic tracks. In Gilman's case, the breakthrough came through direct presidential engagement.

President Trump announced the release on Truth Social, writing that he was "proud to announce that American Citizen Robert Gilman, a former United States Marine, is coming HOME!" Just The News reported that Trump also noted: "During my Administration, we have prioritized bringing home Americans Detained Abroad, and have done so at a level never seen before, returning hundreds of people to their families."

Russia released Gilman without demanding a prisoner exchange or any concessions, a sharp contrast to previous arrangements, such as the swap that freed basketball player Brittney Griner in exchange for convicted arms dealer Viktor Bout. That distinction matters. It suggests the humanitarian argument, backed by persistent diplomatic pressure, carried enough weight on its own.

Gilman's sister credits Trump with saving her brother's life

Gilman's sister, Lexie Hudson, was unequivocal about who deserved credit for her brother's survival. Fox News reported her statement:

"I am so grateful to President Trump for saving my brother's life. There is no other reason that Robert is alive today other than that President Trump heard about the case and took action."

Gilman was reunited with his mother, Nancy, on the plane home. He landed at Andrews Air Force Base and, in a small but telling sign of life returning to normal, requested a cheeseburger upon arrival.

Not everyone was satisfied with the pace of the effort. Senator Ed Markey of Massachusetts acknowledged the outcome but directed pointed criticism at the broader timeline. "It is a tragedy that it took Robert's near-death condition for his case to receive the attention that it required for his release to be negotiated," Markey said.

Markey's criticism raises a fair question, but it also sidesteps the fact that the Trump administration was the one that ultimately got Gilman out. Whatever failures accumulated over four years, the decisive action came from the current White House, not from congressional statements.

Thirteen Americans still detained abroad, and the clock keeps running

Ramsey made clear that Gilman's release, while welcome, does not close the book. He laid out the scope of the remaining problem in stark terms:

"We have 10 others in Russia. We have two designated in Iran. We have one designated in China. Let's hope that he's able to bring all of these folks home as soon as possible."

Those numbers represent real people, Americans sitting in foreign custody while their families wait. The Trump administration's track record of bringing detainees home gives those families reason for cautious hope, but the cases in Iran and China present distinct diplomatic challenges. Trump himself has publicly acknowledged the difficulty of negotiating releases with Beijing, where leverage is harder to apply.

Gilman was detained in Russia beginning in 2022. He was 32 years old at the time of his release. The specific charges or legal basis for his detention have not been publicly detailed, and the exact mechanism of his release, beyond the humanitarian request and direct presidential engagement, remains unclear.

Ramsey said Gilman is now "getting the world's best medical care" at Brooke Army Medical Center. But the road ahead is long. A man who spent 47 days in a dissociative stupor, fed through a nasal tube, subjected to alleged forced drugging and marathon exercise sessions, does not walk out of a military hospital in a week.

Robert Gilman served his country as a Marine. Russia held him for more than four years, and by every credible account, nearly let him die. He is alive today because someone in the White House picked up the phone, and because the man on the other end of the line, for once, said yes without asking for something back. Thirteen more Americans are still waiting for that call.