Thirty-two years of purpose, then nothing
Robert retired from the Minneapolis Fire Department in 2022 after 32 years. Captain, Engine 17. He’d built his entire identity around the job — the schedule, the crew, the sense of being needed. Retirement was supposed to be the reward. Instead, it was a cliff.
“I went from a guy who ran into burning buildings to a guy who couldn’t figure out what to do before lunch. The first month was nice. By month three, I was sitting in my recliner at 10 AM watching cable news and wondering what the point of anything was.”
Then Carol died. His wife of 38 years, pancreatic cancer, November 2023. Seven weeks from diagnosis to funeral. Robert went from lonely to devastated.
“After Carol, I stopped pretending I was adjusting to retirement. I was just existing. My daughter would call and I’d let it go to voicemail. My grandkids would FaceTime and I’d tell my son I was busy. I wasn’t busy. I was staring at the wall.”
His primary care doctor diagnosed major depressive disorder in early 2024. PHQ-9 of 21 — severe. He started citalopram. It helped with sleep but made him dizzy, which was a fall risk his doctor didn’t love for a 66-year-old. Switched to sertraline. Better tolerated, but the depression barely budged. Added mirtazapine. More side effects — weight gain, daytime grogginess — than benefit.
His daughter wouldn’t let it go
Robert’s daughter, a nurse practitioner in Milwaukee, started researching alternatives. She found information about TMS for older adults and called her father’s psychiatrist directly.
“She went around me. Called Dr. Patel and said, ‘My dad is disappearing. What else can we try?’ He told her about TMS. She told me. I said no. She told me again. And again. She’s stubborn. She gets it from her mother.”
Robert’s main objection wasn’t the treatment itself — it was logistics. He’d have to drive to a clinic five days a week for six weeks. In a Minnesota winter. At sixty-seven, with a knee replacement and no Carol to navigate.
His daughter drove up from Milwaukee for the first week. After that, a neighbor from his old fire crew volunteered for carpool duty.
Old dog, new treatment
The clinic near Minneapolis used NeuroStar. Standard depression protocol — high-frequency left DLPFC stimulation, 19-minute theta burst sessions. Robert’s psychiatrist chose the shorter theta burst protocol specifically because of the reduced time commitment.
“I sat in what looked like a dentist’s chair. A technician put this thing on my head and I felt tapping. It wasn’t comfortable, but I’ve broken ribs on the job. This was nothing.”
The technician was a young woman named — Robert pauses — “I shouldn’t use her name. But she was wonderful. Patient with an old man who asked too many questions. She explained what was happening at every step. By session three, we were talking about the Timberwolves.”
Side effects: headache after the first two sessions, manageable with Tylenol. Mild fatigue the first week. Nothing else. His doctor was particularly pleased that TMS avoided the systemic side effects that had complicated his medication trials — no dizziness, no weight gain, no cognitive fog.
When the fog started lifting
Robert noticed it in week three, on a Saturday. He woke up, made coffee, and instead of turning on the television, he walked to his garage. He hadn’t been out there in months. He started organizing his woodworking bench. Spent two hours sanding a birdhouse he’d started before Carol got sick.
“I called my daughter that night. First time I’d initiated a call in I don’t know how long. She picked up and I just said, ‘I built a birdhouse today.’ She started crying. I didn’t understand why until later.”
By week five, his PHQ-9 was 8. Down from 21. He was showering daily again, eating meals he cooked instead of frozen dinners. He joined his old crew for their monthly breakfast at the diner on Lake Street — something he’d been skipping for over a year.
His final PHQ-9 at the end of treatment: 5. Mild. Not zero — Robert is clear-eyed about that. He still misses Carol every day. He still has mornings where getting up takes effort. But the suffocating heaviness is gone.
“Grief and depression are different things. I learned that. I’ll grieve Carol for the rest of my life, and that’s okay. That’s love. The depression was something else — it was a fog that sat on top of the grief and made everything impossible. TMS lifted the fog. The grief is still there, but I can carry it now.”
What Robert wants other seniors to know
He’s become, in his words, “an unofficial TMS evangelist at the VFW.” Three of his friends have asked about it after seeing the change in him.
- Age is not a barrier. Robert’s doctor told him TMS is actually well-suited for older adults because it avoids the drug interactions and side effects that complicate medication management in seniors.
- Ask about theta burst. Shorter sessions made a huge difference for someone who didn’t want to spend 40 minutes in a clinic every day.
- Accept help with logistics. Five-days-a-week treatment is a lot. Robert couldn’t have done it without rides from his neighbor.
- Medicare covered it. After documentation of two failed medication trials, his Medicare Advantage plan approved TMS without issue.
- It’s okay to be skeptical. Robert thought it sounded like “science fiction nonsense.” He’s glad his daughter pushed him past that skepticism.
Names and identifying details have been changed to protect patient privacy. This story is based on composite experiences reported by TMS patients and is presented for educational purposes only. It is not medical advice. Talk to a qualified specialist about whether TMS is right for your situation.