Dr. Swineheart treated Fables with any medical problems. He served as the primary medic in the final defense of the Last Castle, before being shuttled off to the Mundane world. It was near Fabletown where he opened a hospital called the Knights of Malta, treating both Fable and Mundy patients.

When Boy Blue's hand was broken by Baba Yaga, it was Swineheart who performed the surgery to fix it. He also delivered Snow White's seven children.