Visually, Doctor Hurt is based on an unnamed scientist who appears in Batman #156 (June 1963), in a story titled "Robin Dies at Dawn".

A psychiatrist, Doctor Hurt is involved in a program that creates three "replacement Batmen" with the participation of the Gotham City Police Department.

[6] With Joker working as an unreliable ally, Hurt releases a drug into Gotham's air to drive its citizens insane.

Hurt shoots Dick Grayson in the head and attempts to force Damian Wayne to swear allegiance to him.

[10] In the DC Rebirth relaunch, Hurt's immortality is derived from the Hyper-Adapter, a time-traveling device created by Darkseid.

[11][12] Hurt claims to be Dr. Thomas Wayne, the name being shared with a devil-worshiping ancestor back in the 18th century.

Batman initially suspects him to be the actor Mangrove Pierce, dismissing the belief of the third replacement Batman and the Joker that Hurt is the devil; Hurt alludes to this possibility several times using metaphor only, claiming "I am the hole in things...", "the enemy", "the piece that can never fit, there since the beginning", all cryptic statements that relate to the mythology of a demonic figure.

The issue reveals that centuries beforehand, Hurt attempted to summon the demon Barbatos but instead was confronted by the Hyper-Adapter, a hyper-dimensional creature tasked by Darkseid with overseeing Batman's voyage through history after the villain's Omega Effect struck him.

Wishing to help him, the Waynes send him to Willowood Asylum, a reference to a Pre-Crisis story in which Bruce had a mentally damaged brother who was sent to the same facility.

Batman and Dick Grayson conclude this reading of events to be the truth, and impartial flashbacks in the issue appear to confirm it as accurate.

[15] Grant Morrison explains the ambiguity during an interview in Wizard Magazine:[16] There's a doctor who's got some good lines in the original story Robin Dies At Dawn, and he's never named.