Hamas gunmen picked the female hostage out from a cluster of captives in an apartment in the Gaza Strip. They threatened her with a pistol and led her away into a separate room. Then they commanded Keith Siegel to follow.

It had been about a month since Siegel, the woman and roughly 250 others were kidnapped on Oct. 7, 2023, during the Hamas-led attack that set off the war with Israel. The conditions of their captivity in Gaza were unbearable, Siegel said. Meals were intermittent. Water was scarce. Any failure to follow their captors’ instructions risked violent retribution.

As Siegel stepped into the room, panic washed over him: He found himself in the audience of a “medieval-style” trial by torture, he said.

The woman had been bound, and the guards were beating her. They demanded that she “tell the truth,” Siegel said. He was instructed to assist with getting a confession.

“I was told to go into the room and to tell the person that the torturing will continue until they admit what they were being accused of,” he said.

The episode was one of many that defined the horrific experience that Siegel, an Israeli American originally from North Carolina, and his fellow hostages endured in captivity. Siegel was released Feb. 1, after 484 days as part of a short-lived ceasefire deal between Israel and Hamas. Another 59 hostages remain in Gaza, with about 35 presumed by the Israeli government to be dead.

Since Siegel’s release, Israel has resumed its military campaign in Gaza. More than 50,000 Palestinians have been killed in the enclave throughout the war, according to Gaza health authorities, which does not distinguish between civilians and combatants. About 1,200 people were killed in Israel during the 2023 attack that started the war, Israeli officials say.

In his encounter with the female hostage being tortured, Siegel felt powerless to assist. It seemed like nothing he said could dissuade their captors from continuing the abuse.

Now that he is free and working on his recovery, Siegel is determined to draw attention to the plight of those still captive in Gaza.

He and his wife, Aviva Siegel, who was also taken captive to Gaza but was released during a ceasefire in November 2023, have made frequent public appearances. On Israeli media and in an appearance on “60 Minutes,” Keith Siegel has called for international help to secure the hostages’ release. Last week, he and Aviva Siegel appeared with President Donald Trump at a National Republican Congressional Committee dinner to thank him for his role in the most recent round of hostage releases.

In an interview with The New York Times, Keith Siegel, 65, described the physical and psychological distress he and his fellow hostages endured at the hands of their captors. He outlined a pattern of abuse similar to what other released hostages have said about their time in captivity.

Some months after witnessing the female hostage’s torture, Siegel’s captors forced him to deliver a video message. He desperately hoped to use the opportunity to project strength to his family, he said, but he broke down in tears during filming.

Siegel hoped that his captors would cut that scene. Instead, it featured prominently in the final video, which he saw by chance a few days later in an Al Jazeera broadcast on his captors’ TV. Siegel was heartbroken and severely distressed, he said. He could not improve his circumstances, but he had at least hoped to allay his family’s anxiety.

“That was very, very hard for me to think that my family would see that,” Siegel said.