It Still Stings: How Grey’s Anatomy Gave Alex Karev a Fate Worse Than Death

Editor’s Note: TV moves on, but we haven’t. In our feature series It Still Stings, we relive emotional TV moments that we just can’t get over. You know the ones, where months, years, or even decades later, it still provokes a reaction? We’re here for you. We rant because we love. Or, once loved. And obviously, when discussing finales in particular, there will be spoilers:

Few shows stay on the air long enough to outlast their entire first spinoff series, earn a second spinoff series, and then ultimately soft-reboot the original series itself by transplanting in a new young cast into the same spots where the old guard once stood­—but of course, few shows are Grey’s Anatomy. Created by Shonda Rhimes in 2005, the medical drama is now on its nineteenth season and just survived the departure of its titular character, Meredith Grey (Ellen Pompeo), without missing a beat. In fact, before Meredith made her (weirdly anticlimactic) exit, the series shifted its focus to a new crop of interns, several of whom bear remarkable similarities to Meredith and her original class of five.

Taking Meredith’s place as the legacy hire is Dr. Lucas Adams (Niko Terho), the nephew of rockstar neurosurgeons Derek (Patrick Dempsey) and Amelia Shepherd (Caterina Scorsone). Filling Cristina Yang’s (Sandra Oh) place as the brilliant and ambitious no-nonsense overachiever is Dr. Benson Kwan (Harry Shum Jr.). Dr. Jules Millin (Adelaide Kane) comes from a working-class background just like Izzie Stevens (Katherine Heigl). And while neither Dr. Simone Griffith (Alexis Floyd) or Dr. Mika Yasuda (Midori Francis) are precise analogues for George O’Malley (T.R. Knight) or Alex Karev (Justin Chambers), there are definite echoes of the original cast members spread throughout the group.

I just wish those echoes didn’t make me so cranky. Because by reminding me of the halcyon days of Meredith, Cristina, George, Izzie, and Alex, I’m also forced to recall just how awful Alex’s exit was.

As far as terrible Grey’s Anatomy send-off storylines go, it would take a lot to top the final episode of George O’Malley, who was hit by a bus and rendered unrecognizable for most of his swan song, until he finally managed to communicate his identity to Meredith right before dying in surgery. But George’s exit was arguably preferable to that of Alex Karev, whose bizarre reasons for his abrupt departure bore even less resemblance to his character than John Doe’s mutilated face did to George.

Of course, the reason behind Alex’s sudden exit is because series original cast member Justin Chambers decided to leave Grey’s Anatomy for personal reasons in the middle of its 16th season. I don’t know the reasons behind Chambers’ decision and don’t want to speculate, since it’s none of my business. I hope he felt (and still feels) good about his departure, and I wish him well.

I acknowledge that the unplanned departure of a character who had nearly reached the pinnacle of his series-long trajectory undoubtedly threw the Grey’s Anatomy writers for a major loop. Alex was clearly being set up for success: being hired as Chief of Staff and Chief of Surgery for Grey Sloan Memorial’s rival Pacific Northwest General Hospital, blissfully happy with his wife Jo (Camilla Luddington), best friend and right-hand-Person to Meredith Grey, and almost definitely poised to soon become a father. What’s more, at the time of his departure, Chambers was one of only four remaining original cast members, along with Pompeo, James Pickens Jr., and Chandra Wilson. How does one simply write off a character that has been so integral to the fabric of the series for a decade and a half, especially with no notice and without the actor even available to film his final episode?

Not. Like. This.

Before we get into what Alex did—or rather, what was done to Alex, since I still refuse to believe Alex himself would have willingly done any of this—let’s go back and quickly recap his impressive journey since we first met him in the pilot episode.

Alex Karev was introduced as a cocky, misogynist jerk known mostly for giving nurses STDs, objectifying and condescending to his fellow interns, and freezing up during surgery. He was, to put it mildly, The Worst, and remained that way for much of Grey’s Anatomy‘s early days.

Eventually, though, he started to grow up. He fell in love with fellow intern Izzie Stevens, and even when she broke things off with him, she carried a soft spot for him. He developed a surprising aptitude for pediatrics, and an even more surprising gentle rapport with his young patients. And as he was continually challenged professionally and emotionally, he found that he was capable of rising to those challenges. Over time, healthy confidence began to replace machismo and arrogance, and his best characteristics were finally able to shine through.

At the end of Season 5, while Izzie was undergoing cancer treatment, Alex and Izzie decided to get married. But soon after, Izzie decided that she didn’t want to be with Alex anymore, and she took off, exiting the series (off-screen, Heigl asked to be released from her contract to spend more time with her family), abandoning the embryos they’d had frozen during her cancer treatments (or so we thought—more on that in a minute), and mailing him divorce papers.

Alex was understandably devastated, and still had a lot of growing up to do, but ultimately found his footing. He specialized in pediatrics and rose through the ranks to become an attending surgeon. He put his selfishness aside and invested in his friendships, to the point where he became Meredith’s local “Person” after Cristina departed at the end of Season 10. Several years (and many short-lived flings) later, he found himself falling for then-resident Jo Wilson, and after dating for a few years, decided to propose. They got married at the end of Season 14 in a ceremony officiated by Meredith Grey herself, and spent the next season and a half settling into married life. And although marriage came with its hardships, especially when Jo suffered a mental breakdown after discovering she was conceived as the result of sexual assault, he rose to meet them.

At the beginning of Season 16, when Jo fears that she is now too broken to be loved and offers Alex the opportunity to leave, he instead gets down on one knee and proposes to her all over again, promising that “I want to grow old with you, no matter what.”

Which would be a lot more meaningful if he did not leave her completely out of the blue just a couple short months later.

The writers of Grey’s Anatomy would have us believe that after everything he went through, including a relationship with Jo that lasted years longer than he’d even known Izzie, Alex Karev would abruptly abandon his life partner for the woman who abandoned him a decade before. And who, apparently, secretly had his kids using frozen embryos he thought no longer existed. When he told Jo he was going to care for his sick mother, and subsequently sent a series of weirdly disinterested text messages to his wife and friends in Seattle, he was really going to visit Izzie and their kids on her farm. Where he then decided to remain, permanently. 

No. I think not.

Right before he disappeared from the show, Alex also managed to snag the job of Chief of Surgery and Chief of Staff for the struggling Pacific Northwest Hospital, a huge accomplishment for the guy who once froze up during elevator surgery. But now he’s tossing that away too, giving up the career he’s worked so hard for.

I believe that the Alex Karev we’d come to know by Season 16 would put his family before his career if he had to choose. I just don’t believe he’d choose Izzie over the family he was making with Jo. And since Jo would never have kept him from his kids with Izzie, he could have been a father, and kept his vows to his wife, and achieved professional success.

The Alex who would throw all of that away for Izzie isn’t the Alex of Season 16. It’s the Alex of Season 6, whose whole world revolved around Izzie, who didn’t think much of himself as a doctor or as a friend, and who was frankly too immature to realize when he was making bad decisions. Perhaps the problem is that the show switched hands a couple times between, from Shonda Rhimes to Krista Vernoff, who took over for Rhimes as showrunner from 2007 to 2011. Vernoff’s time on the series spanned Alex and Izzie’s marriage and Izzie’s subsequent departure, and she then returned as showrunner for Season 14. Maybe that’s why it felt like Alex’s “Dear Jo” exit was written for a character we haven’t seen in a decade. Maybe that’s why it crumpled up 16 years’ worth of character development and tossed them in the garbage.

I think there could have been a scenario in which the writers wrote Alex off the show in a satisfying way, extenuating logistical circumstances and all. Maybe he died in an accident while visiting his mother, or even sacrificed himself saving a child. Maybe his mother, who he’d already established was unwell, got confused and accidentally poisoned him, then panicked and faked his text messages to his wife and friends in Seattle, unable to deal with the trauma of his death. Maybe a thousand different scenarios (most, if not all, probably ending in death), none of which are living on a farm with Izzie.

But since we didn’t get any of those endings, the best I can do for Alex is believe that the ending we did get is all a ruse. Maybe it wasn’t Alex who wrote those letters and sent those uncharacteristic text messages at all. Maybe it was Izzie, seeing ghosts again, who somehow lured Alex to her farm, killed him, and buried him in the backyard. Maybe she’s been impersonating him all along, writing the fictitious happy ending she wishes she’d had.

It would suck. But given a choice between the death of Alex Karev and the assassination of his character, I’ve got to go with death. At least it would be better than what we got.  

Lauren Thoman is a Nashville-based freelance pop culture writer whose writing has appeared in numerous online outlets including Parade, Vulture, and Collider. She is also the author of the novel I’ll Stop the World. Find her at her website, or on Instagram, Twitter, or Facebook. 

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