Marc Fogel is in a dark place after a multinational deal left him in a Russian prison while other Americans being held there came home.

“It’s like I’m in a bottomless pit and it keeps getting worse,” Fogel said in a phone call with family and friends Saturday.

TribLive was given access to a 20-minute recording of the call, which provides a glimpse of Fogel’s mental state and his reaction to the prisoner swap deal that excluded him.

“It’s just incomprehensible to me,” he said. “I lay awake all night, and my head just runs and runs and runs. The anger and the frustration.”

The Oakmont teacher, 63, just marked his third year in a Russian penal colony after being arrested in August 2021 for possession of 17 grams of medical marijuana legally dispensed to him in Pennsylvania for years of debilitating back, knee, hip and shoulder pain.

On Thursday, 24 prisoners were shuffled in a deal that involved not just the United States and Russia, but Germany, Norway, Belarus, Slovenia and Turkey.

America released four criminals, Germany gave up a notorious hit man and Russia freed a number of its own dissidents, as well as Wall Street Journal reporter Evan Gershkovich, Marine veteran Paul Whelan, Radio Free Europe journalist Alsu Kurmasheva and Washington Post columnist Vladimir Kara-Murza.

But not Fogel, who taught history at the now-shuttered Anglo-American School in Moscow. He asked on the call whether it was true that America negotiated for the release of some Russians while leaving him behind.

“What can anybody in my shoes think and act on and do? I’m just beyond words. I got nothing. I’ve been lying in bed for two days,” he said.

This is the third time Fogel has been in this position. Marine veteran Trevor Reed was traded for a Russian drug smuggler in April 2022. WNBA star Brittney Griner was swapped for arms dealer Viktor Bout in December 2022.

“I’m shocked and sickened and out of breath and out of energy, and I just feel like my soul is dead,” Fogel said.

He also went into more detail about his physical health.

“I have spent 101 days in Russian hospitals. I have received about 300 injections and taken over 1,000 tablets, pills, whatever you want to call them, and I am just worn out,” Fogel said.

The family previously provided X-rays showing the screws in Fogel’s spine. On Sunday, they gave the Trib additional documentation — a notarized letter from the doctor who prescribed Fogel’s marijuana. Fogel has two bulging discs in his spine, as well as degenerative disc disease and osteoarthritis. He had spine laminectomies in 1992 and 2002 and a disc fusion in 2013.

The marijuana was prescribed only after trials with multiple other medications, beginning in July 2020 — 13 months before his arrest.

“I’m sitting here talking about an unbelievable situation, and there isn’t one shred of emotion in me that seems to care about what’s happening. That is so the antithesis of who I am, who can be a very emotional person,” Fogel said.

“(It’s) like I’m not Marc at all. Like I’m not even a shell of the person that I was,” he added. “(It’s) dark and deep and dangerous and scary. It’s really tough to control it, and I am in that place right now.”

While the State Department, National Security Adviser Jake Sullivan and President Joe Biden have all responded to reporters, saying work will continue to bring Fogel home, there are no specifics.

In a July 13 conversation with Fogel’s mother, Malphine, in Butler, former President and Republican nominee Donald Trump also committed to bringing Fogel home if he wins the White House. Malphine Fogel expected to hear him say so during his speech, but that was interrupted by the assassination attempt that injured Trump, killed Corey Comperatore of Buffalo Township and put two other local men in the hospital.

The designation of “wrongfully detained” has been a stumbling block. While Gershkovich, Whelan and Griner had the designation, Fogel does not. The State Department has relied on a humanitarian appeal for his release, which Russia has ignored.

“That designation thing is just so flummoxing,” Fogel said.

The family continues to pursue the designation, Malphine Fogel firmly told her son on the phone call.

“Nobody’s giving up. You can’t give up either. We’ve gotten further than we ever have before, and it’s just gotta happen,” she told him. “I don’t want you to be discouraged. I know you have reason to be, but we’re doing better than we’ve ever done. You hear me? You hear me?

After a period of silence, Fogel responded, “I hear you. Loud and clear. … It’s just so cruel. I love you, Mom.”

Lori Falce is the Tribune-Review community engagement editor and an opinion columnist. For more than 30 years, she has covered Pennsylvania politics, Penn State, crime and communities. She joined the Trib in 2018. She can be reached at lfalce@triblive.com.