In the early hours of October 7, 2023, sirens shattered the calm across Israel, signaling the start of the deadliest assault on the Jewish people since the Holocaust. What began as a peaceful morning quickly escalated into an event that claimed hundreds of lives through murder, kidnapping, and other violent acts. The attack marked a pivotal moment, profoundly impacting Israeli society and the nation’s approach to defense.
Seventeen years removed from active duty, Tuvia Book, a former combat medic with the Givati Brigade, found himself compelled to return to service in the wake of the crisis. Having aged out of reserve duty, he faced initial resistance but ultimately rejoined the Israel Defense Forces (IDF) through persistence and determination. “I had to fight back,” Book recalled, emphasizing a collective resolve among Israelis to confront the challenges posed by the attack and its aftermath.
Book now serves in Palmar, a combat medical extraction unit that works closely alongside the elite Unit 669, the IDF’s air force search and rescue team. These units operate on the front lines, providing immediate medical evacuations under hazardous conditions. Since the onset of the conflict, Palmar has conducted over 3,000 evacuations, including upwards of 400 helicopter extractions. While high-profile rescues, such as that of singer and actor Idan Amedi, have drawn media attention, many missions remain unheralded.
Advanced medical protocols characterize the unit’s operations. Drawing upon innovations aligned with Israel’s reputation as the “Start-Up Nation,” the medical teams ensure rapid treatment within the crucial “golden hour” following injury. The teams carry portable blood supplies, embed doctors and surgeons in the field, and utilize real-time digital communications to prepare hospital staff before casualties arrive, enhancing the chances of survival. According to Lt.-Col. “D.,” the unit’s commander, their presence reassures soldiers by effectively opening "the door to the hospital" amid combat.
The integration of diverse personnel is a hallmark of the IDF’s contemporary structure. Medics, paramedics, doctors, and combat soldiers serve together, often under fire, enabling the swift evacuation of wounded personnel. The significant participation of women in integrated units represents a marked departure from previous practices and has had a notable impact on military operations during this conflict.
Book reflected on the broader societal changes the recent war has fostered within Israel. “What moves me most is who stands beside me,” he noted, citing the unity among religious and secular citizens, immigrants and native-born Israelis, as well as Jews and non-Jews. This solidarity transcends political and social divides, reinforcing a shared commitment to national defense. Book described this cohesion as central to Zionism—the responsibility of one people for one land.
Having spent more than two years serving on the Gaza front and close to a year on the Lebanon front, Book described the experience as both exhausting and profoundly meaningful. The contrast between military camaraderie and divisions in broader society remains striking. To share these perspectives, he authored *Heroes of Palmar: How One IDF Unit Revolutionized Combat Medicine in Gaza*, a recent publication highlighting stories of resilience, unity, and dedication amid warfare.
One of those saved by Book’s unit, Idan Amedi, publicly acknowledged the vital role of the rescue teams during his comeback concert after 18 months of rehabilitation. “Thanks to whom I can stand on this stage," Amedi said, expressing gratitude that echoed a shared commitment among the medical personnel and soldiers they protect.
After three years marked by conflict and recovery, Book and his colleagues continue their mission of bringing wounded soldiers to safety—supporting not only individual lives but the future of Israel and its people.