Alex Karev

"Today's the day my life begins. All my life I've been just me. Just a smart mouth kid. Today I become a man. Today I become a husband. Today I become accountable to someone other than myself."

- Alex Karev (to Izzie, on their wedding day)

Alex Karev is a Resident Surgeon working at Seattle Grace Mercy West Hospital. Alex is an eager and competitive surgeon, but he can also be self-absorbed and overconfident; he only wants to work on cases that he feels are interesting. His offensive behavior and poor attitude cause him to be extremely disliked by doctors and patients alike. However, it is slowly revealed that Alex does care for others and is very kind. He actively plays down his soft side, adopting a brash and cocky attitude to project to other people. Alex married Izzie Stevens, but eventually divorced after she abandoned him.

Childhood and growing up
Not much is known about Alex's childhood other than Alex's dislike for his father. His father never took him to a park as a child, and Alex referred to himself as literally being raised in a bar. As a teenager, Alex Karev became a wrestler. He did so because his father, a musician and drug addict, used to beat his mother. Alex beat his father and put him in hospital. When discharged, Alex's father never went back home. After he left, Alex' mother sank into a depression and Alex took care of her.

After Alex's grandmother died, he had a dream where she told him not to play with his bits.

Personal life
Despite the callous image he projects, Alex is particularly affected when he treats addicts and abused children because of his childhood background. He initially refused to install a central line for a Demerol addict because he did not want to feed his habit. He was also able to connect with a teenage boy, whose abusive father hit his mother in “Enough is Enough”.

Izzie realized that Alex was not as insensitive and cruel as he portrayed himself to be. She began a tentative friendship with him, to the shock of Meredith, Cristina and George. Later, Meredith’s opinion of Alex changed for the better when he offered to listen to her problems with her mother, Ellis.

In “Who’s Zoomin’ Who”, George contracted syphilis from Alex through Olivia. It was revealed that Olivia was already dating Alex when George asked her out. Olivia subsequently broke up with Alex after realizing how much she liked George. Furious at the revelation that Alex was the cause of his syphilis, George punched Alex in the face. That night, Joe, the owner of Emerald City Bar was admitted to Seattle Grace Hospital, and in discussions with Joe it was revealed that Alex was a regular at Joe's bar every night and that he and Joe had become close friends. When George finds a way to pay for Joe's hospital bills, the animosity between George and Alex is dissolved after Alex gives George a hug.

Romantic life
A mixer was held for the new interns, and it was at this mixer that he met and presumably hit it off with nurse Olivia Harper, as he is shown leaving the event with an arm around her.

When Alex found out that Izzie Stevens was an ex-lingerie model, he obtained a copy of her advertisement and proceeded to paste copies all over Seattle Grace. Although he succeeded in humiliating her, she turned things on him by stripping to her underwear in front of him and several other interns, reminding him that her modeling is the reason why she is debt-free while he is “sitting on two hundred grand of student loans”.

Alex eventually asked Izzie out on a date in “Deny, Deny, Deny”. However on that very day, he found out from the Chief that he failed his medical board exams. This caused him to suffer from a crisis of confidence, leading him to treat her shabbily during their date. His confidence took another blow when he froze up during a makeshift emergency surgery in an elevator during a power outage, and George had to operate on the patient himself. Izzie, still furious from the horrendous date, refused to speak to him. Afterwards in Joe’s bar, he went up to her and kissed her passionately, rekindling their budding relationship. However, their sex life hit a bump when Alex had difficulties performing. Meanwhile, his confidence in his medical skills further deteriorated after he accidentally administered a wrong dosage saline solution, paralyzing the patient. In a moment of vulnerability, he slept with Olivia and was caught in the act by Izzie, effectively ending their relationship.

Izzie subsequently found out about it and blew up at her friends for helping Alex. She eventually forgave him, but ruled out getting back together with him. Alex passed his re-test and became a full-fledged doctor. In “It’s the End of the World”, the dire situation of a bomb scare caused Izzie to realize that she should act on her feelings. She accosted Alex and the two proceeded to have sex in a linen closet. They continued to sleep together several times over the course of the day.

In “What Have I Done to Deserve This”, Izzie’s patient Denny Duquette was re-admitted after he suffered a heart failure. Alex was jealous of Izzie’s concern for Denny, and tried to get Denny to back off by telling him that he was with Izzie and there is a good chance that he would die from his failing heart anyway. She confronted him, and he told her that she cannot get involved with her patients. However, Izzie realized that she didn't have to settle for Alex. Offended when Alex referred to the still-living Denny as a "corpse", she dumped him saying, "Just so we’re clear, we’re over. On your very best day, that 'corpse' is twice the man you will ever be. You're not good enough for me, Alex. You're not good enough for anyone."

When Denny died from a stroke, Alex picked up a devastated Izzie and told her that the dead man was no longer Denny, the man she once loved. In “Staring at the Sun”, Alex realized that his feelings for Izzie had not diminished since she dumped him, and impulsively kissed her in the stairwell. Izzie had yet to get over Denny and told him she cannot commit in a relationship with him just yet, and he understood. However in "Scars and Souvenirs", Alex claimed his lack of interest in Izzie and has appeared to have gotten over her.

Meanwhile, Addison discovered Alex’s better side and found herself attracted to him. To some degree, Alex was also attracted to Addison as they subsequently shared frequent meaningful looks. This culminated in an actual kiss in Joe’s bar. However, he later told her that he only wants to work with her professionally, and is not interested in pursuing a romantic relationship with her.

During a ferry accident, Alex found a severely injured pregnant woman crushed under a pylon. He rescued her from the debris, and encouraged her to stay alive. The pregnant Jane Doe subsequently became hysterical after realizing she could not remember anything, and turned to Alex for support, thinking that he was her husband. Alex showed much concern for her and constantly checked on her progress, bonding with her in the process. He also helped her pick out a new face for reconstruction, as well as a new name "Ava". As Alex spent more time with Ava, he became increasingly attached to her, spending most of his time checking on her progress and doing research. This led Addison to accuse him of being too emotionally involved with a patient, but he countered saying that he was just being prepared. In the heat of the argument, Addison kissed him and pushed him into an on-call room, where the two had sex. However, Alex rebuffed Addison's subsequent advances, after learning she wanted a committed man to have kids with, something which he was not ready for.



For a good while he remained single or had no exclusive dates with other hospital staff. His feelings for Izzie eventually came back and when she gave him an ultimatum (to pick between the nice Alex and the jerk Alex) he chooses nice and they begin to go out again. He starts dating Izzie exclusively and after winning his solo-surgery he tells her he loves her.

Following the revelation of her cancer, Alex snooches in a cup as they harvest Izzie's eggs in case they ever want a child. When Izzie is discovered to have an inoperable tumor, Meredith and Dererk gave their wedding to Alex and Izzie and the two marry.

After the death of George O'Malley, and the merger between Seattle Grace Hospital and Mercy West Hospital, Izzie was fired partly because Alex told the Chief Webber she couldn't handle the pressure of working because she was still recovering. He meant to protect her but Izzie didn't think so and she left Seattle, leaving Alex with unpaid medical bills and no ideas of where she was.

Alex remained worried for weeks trying to join her because she had to treat her cancer and she didn't show up to her round of chemio. When she finally got back, to get some help for an old teacher, they didn't managed to work their problems out and Izzie left once again.

Alex decided to not wait for her and he slept with Lexie Grey just before Izzie came back home. She tried to convince him that they could start over but he had moved on and he decided to break up with Izzie. So Izzie left Seattle for apparently the last time, telling she couldn't stand it.

Later, she sent the divorce paper to Alex, with her name signed on it. Alex then signed his name, kissed Lexie and they walked out of the hospital, hand-in-hand.

Career
Alex Karev is a former wrestler at the University of Iowa, and studied medicine on a wrestling scholarship. Alex prides himself on his honesty, which often lacks tact and can verge on being crude, brutal, and insensitive. This contributes to his poor bedside manner. However, Alex does have a moral code and is the only doctor who tells the truth to patients who make bad decisions about their health, at the risk of offending patients and getting kicked out of surgical cases. Alex is also the first intern to decide on his specialty – plastic surgery. While it seemed at first that he chose that specialty due to "frat-boy" superficiality, the real reason was because plastic surgery patients “sign up for the pain they get”. he has unwittingly been drawn to obstetrics and gynecology after having several bad experiences in plastics. Alex seems to have some talent in OB/GYN after serving as Addison’s intern for a while.Alex Karev secured a position in the surgical residency program at Seattle Grace after graduating from medical school.Although first he was an intern of Jeremy, Alex was reassigned to a new resident Dr. Miranda Bailey, to the disdain of the other interns under her. His frequent sexist remarks and overt come-ons made him even more disliked by the interns, who proceeded to dub him “evil spawn”. He became even more hated when he hijacked an open-heart surgery that rightfully belonged to the other interns. After which, he proceeded to taunt a furious Meredith who attacked him in retaliation, calling him a “frat boy bitch”.

Alex confided in Meredith about his failed medical boards and she decided to help him study, roping in Cristina and George to help as well.

Alex’s streak of brutal honesty caused Addison to be on the receiving end of legal action, when he persuaded a patient’s husband to sue the hospital for Addison’s “mistake” in “Blue’s for Sister Someone”. Furious, she informs a stunned Alex that he would be placed permanently under her service. Despite his lack of interest in obstetrics and gynecology, he has exhibited some flair for it as he managed to deliver a premature baby by himself.

When acclaimed plastic surgeon doctor Mark Sloan took up a position at Seattle Grace, Alex leapt at the chance to pursue his interest in plastics. He wanted Addison to release him from her service, and she did, but not before telling him that he would miss her. It becomes clear that Mark is a poor teacher, only delegating menial tasks to Alex. Alex gradually developed distaste for plastics after serving as Mark’s intern, and found himself drawn back to Addison’s surgeries. Addison left Seattle Grace and Alex found himself without any preferences for any specialty.

When Rebecca Pope returned to Seattle Grace and revealed she was pregnant, Alex took up some shifts at the Emerald City Bar.

When Cristina was chosen to pick the first resident to perform a solo surgery, she chose Alex who performed a below the knee amputation.