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Big Boss' body double/phantom, who appears in MGSV:TPP. He is most noticeable by his appearance. He has a chunk of metal sticking out of his forehead, meant to look like the devil's horn. His left arm is bionic, and is bright red, possibly meant to look like blood. In 1975, he was known as "The Medic". He was involved in a freak accident that year. A bomb exploded nearby, causing him to jump in front of Big Boss to protect him. This sent him into a nine year coma, along with Big Boss. He was supposed to be assassinated by Cipher's XOF forces, but they all failed. One woman, known as Quiet, was severely burned, and fell out a window, plummeting to her death. The man who saved him, was none other than Big Boss, who told Venom Snake to call him "Ishmael". Venom Snake met up with Ocelot after escaping the burning hospital in Cyprus. He soon after rescued Kazuhira Miller from the Soviets. After that, he took command of Diamond Dogs. (Also a David Bowie song.) Miller and Venom had only one thing left to do... take revenge.

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