A rescue drill was performed by Unit 669 of the Israel Defense Forces on April 2, 2014. Photo by Gershon Elinson/Flash90.
One of the most critical needs supported by American Friends of Unit 669 is mental-health care and therapy, especially for post-traumatic stress disorder.
The key to saving soldiers’ lives in the field is to provide immediate attention to their life-threatening injuries with a rapid evacuation to a tertiary care hospital. I learned this during my visits to Soroka Hospital, Israel’s tertiary care hospital near the Gaza border. As a surgeon, I understand that minutes can mean the difference between life and death. For Israel and the Jewish people, saving every life is paramount. At Soroka, soldiers are alive thanks to the risks taken and the expertise of Israel’s elite special forces rescue and extraction Unit 669. Over 90% of soldiers injured during this war were rescued by Unit 669.
I had the privilege of interviewing Unit 669 members and hearing extraordinary rescue stories that happened almost daily without media attention because of the sensitivity of the missions in Israel’s fight for survival on seven fronts.
In quiet times, the demands and training require reserve soldiers to train two months every year, a significant but necessary burden for these dedicated young men and women, including elite physicians, nurses, and support staff. When not at war, 669 acts as a rescue unit for the nation, from ordinary accidents to terror attacks.
Guy is a unit member, and he is in his last year of medical school, transitioning between combat missions in Gaza, Syria, and Lebanon while still participating in his hospital rotations to complete his medical degree. It is little surprise that 25% of Unit 669 veterans go on to medical school.
During my six visits on the front lines during this war, I routinely met with physicians, tech executives, accountants, lawyers, and every occupation under the sun, who transitioned from home to war and back again, leaving families behind for months at a time. In Guy’s case, he is newly married.
Guy’s most harrowing rescue mission began in rural Georgia a week before Oct. 7. He was traveling with his family, eating at a local restaurant, when his father suffered from a cardiac arrest, and Guy needed to resuscitate him. Guy told me he could not find the words to express his fear and the tension of putting his skills to use on a family member, followed by a harrowing three-day extraction journey, before bringing him back to Israel. His father’s case was anything but routine; seeking out and finding the correct medical help in Georgia was a miracle.
Returning to Israel, exhausted and focused on his dad in the ICU, he received a call at 7:30 a.m. on Oct. 7 from his unit. Once updated on the situation, he went directly to Tel Nof airfield, 669’s base of operations, to be transported to the front. No helicopters were available to transport his team in the first hours of the war, so he and his fellow soldiers drove a white pickup truck to the Gaza envelope communities, which was eerily similar to the ones Hamas used, making them a potential target to be struck by IDF pilots and drones.
The team came upon an open field and a traffic jam. They encountered a casualty scene beyond comprehension, beginning to triage the injured. Guy noticed something odd; many were dressed up in what appeared to be Indian attire, and unbeknownst to him, they arrived at the scene of the Nova Music Festival massacre. Soon afterward, they were ordered to go to Nahal Oz, shifting into combat mode with another special forces unit to take back the Kibbutz. They moved to Kfar Aza and, throughout the following evening, extracted the injured from the Kibbutz. Before sunrise, they were sent to Kibbutz Be’eri on Oct. 8, where combat continued until noon. They joined another unit to act as a rapid combat force, extracting the injured in pickup trucks and Hummers.
While coordinating with other special forces, United 669 prioritizes focusing on who can be saved, secondarily thwarting the active terrorists. Guy said there were many civilians injured and children killed in their own homes. But the team’s focus remained on the casualties as the terrorists continued to swarm the communities, followed by ordinary Gazan civilians, who joined them.
Today, a year and a half later, the names of the Kibbutzim are etched into our consciousness, like the roster of Nazi concentration camps, which brings a chill to anyone who knows the depravity of Hamas and their Palestinian collaborators. Oct. 7 was the worst single-day massacre of Jews since the Shoah.
When Unit 669 gets involved, something has gone horribly wrong, as most combat missions proceed as anticipated. Guy told me that to survive during a mission, you go into “functional robot mode.” At his father’s urging, Guy kept a diary of his experience from the beginning of his service, telling the story of 669, which was anonymously published and became a best seller in Israel. Former Israeli government spokesman Eylon Levy translated the book into English, which led to a second book of 669’s Oct. 7 experiences called “The Rescue-October 7 through the Eyes of Israel’s Para-Rescue Commandos.” The first book, “The Story of 669,” will be published later in 2025.
Unit 669, like many special forces in Israel, is family. The feeling of successfully extracting a soldier, more than 3,000 times since this war began, is exhilarating, but it takes a toll. 669’s soldiers, like the rest of the nation, are still in traumatic distress, which is the great health problem the State of Israel will confront for decades to come. 669, like other units in combat, have had to extract friends and family, and the mental stress doesn’t show in a wound, but it is equally disabling. The residual mental health issues, even for those with no battle scars, are immeasurable.
There are too many stories to tell, Guy explained. However, when returning to medical school after being with 669 in Gaza, he spends one week in combat and the next back on medical school rotation. He received a voice message from a friend who heard a call on the radio about a story when he was in Gaza extracting soldiers from an explosive incident. The triage protocol puts the most injured with the most experienced physicians in a helicopter, while paramedics attend to the less severely injured.
The priority is hemodynamics, ensuring the soldier has enough blood and pain is controlled. On this particular mission, so they didn’t overwhelm Soroka, the closest hospital to Gaza, they went to a Jerusalem hospital, a 20-minute flight away, with five casualties.
669 emphasizes treating people with compassion. Guy’s patient just saw his commander “blow up in front of his eyes,” and how Guy interacts with the young man could be what is most important in minimizing the potential for PTSD. He saw the injured young man was religious, and it was almost Shabbat when they landed at the hospital. Guy asks him who do you want to call. Guy tells him to call his mother and tell her he is okay. That phone call is the one everyone in Israel is afraid to get.
A few months later, Guy drove up to Lebanon, and he heard a mother on the radio just before Shabbat speak about a paramedic from 669 named Guy who treated her injured son in Gaza. Tragically, she said, he was killed in Lebanon.
It is hard for Americans, even those who are deeply connected to Israel, to understand how small Israel is and how everyone is connected by only a degree of separation from another Israeli.
Yediot Aharonot reported on a Unit 669 rescue. “On the first night of the Gaza ground operation, the wounded young armored corps soldier that Sgt. Maj. (Res) Dr. Y. was treating, died in his arms…His mother is the first thing I think about in such situations. Someone’s son is now lying wounded somewhere in Gaza, waiting for us to come get him out of there. If his mother knew what was happening, what wouldn’t she do to save him?”
Most operations are covert and not released for publication. However, there is nothing that compares to the feeling of rescuing a person and getting them home safely.
Open-source information has reported they have been intimately involved with hostage rescues in Gaza, as well as the most challenging special operations destroying Iranian facilities in Syria.
Because of the small nature of Unit 669, always in pressure-cooker situations, all members must pass the commander’s course because they must be leaders in a moment’s time.
One of the most critical needs supported by the American Friends of 669 is PTSD support and therapy. Every soldier has seen the worst, most unimaginable situations, including rescuing family members as well as injured fellow 669 soldiers.
Every IDF soldier, especially in the elite combat units, is desperately going to need help managing the soldiers living with PTSD. I know this firsthand, working with the Maglan special forces units for over 10 years and now with Unit 669.
To learn more, please contact American Friends of Unit 669 at www.afu669.org/about. We must not forget the families and soldiers who will take the mental wounds of the war with them for the rest of their lives. It is up to us here, living comfortably in America, not to forget those who continually endure the scars of war. ◼️
An edited version of this article was originally published in the Jewish News Syndicate on March 5, 2025.
Dr. Eric R. Mandel is the director of MEPIN, the Middle East Political Information Network, the senior security editor of The Jerusalem Report, and a contributor to The Hill and The Jerusalem Post. He regularly briefs members of Congress and their foreign-policy advisers about the Middle East.