Alfred Pennyworth has also provided first aid up to and including suturing wounds and removing bullets, as well as occasional tactical support. He is also able to perform arthroscopy and other advanced medical procedures, thus limiting, if not eliminating, the need for hospital medical treatment even in the face of grievous injuries, helping to maintain Batman's secret identity by ensuring that Bruce Wayne has no need to visit hospitals for wounds inflicted as Batman. Nevertheless, Batman still requires professional medical treatment when Bane breaks his back ("") and Hush's machinations result in his suffering a skull fracture (""). On these occasions, Alfred
Outsider (comics) box and tells the heroes that the box is not magic, but science, that was created on his world and can only be opened by someone from his world. He explains that the box opens a gateway to another universe, his homeworld; the birthplace of evil. It is revealed that The Outsider is actually from Earth-3 and is that world's version of Alfred Pennyworth who works as the butler to Owlman. During the "Forever Evil" storyline, Pandora tries to get answers from the Outsider on how to reopen the portal to Earth-3, but he points out that she is asking