When does Alex leave Grey's Anatomy?

Dr. Alex Karev, portrayed by Justin Chambers, left the American medical drama series Grey’s Anatomy in season 16. Alex’s farewell letters were received and narrated through his voice-over in episode 16 titled, “Leave a Light On”. ABC broadcast the episode on March 5, 2020.

Following his final in-person appearance in the November 14, 2019 episode "My Shot," the 350th episode that focused on Meredith's medical license trial, Chambers's departure from the series was announced on January 10, 2020. Alex returns to Izzie and their kids after leaving the Grey Sloan Memorial Hospital.

Grey's Anatomy is an American medical drama that centers on the personal and professional lives of attendings, residents, and surgical interns at the fictional Seattle Grace Hospital, which was subsequently renamed the Grey Sloan Memorial Hospital. The pilot was written by Shonda Rhimes, who also served as executive producer, head writer, and showrunner until her departure in 2015. The show centers on Dr. Meredith Grey (Pompeo) for most of its run, following her journey from surgical intern to fully certified physician to the chief of general surgery at the hospital.

Episode Synopsis of Alex Karev’s exit from Grey’s Anatomy

The episode begins with an archival video of James Pickens Jr.'s character Richard Webber's speech to the initial interns in the pilot episode. Meredith Grey (Ellen Pompeo), Izzie Stevens (Katherine Heigl), Alex Karev (Justin Chambers), George O'Malley (T. R. Knight), and Cristina Yang (Sandra Oh) are among its cast members.

In her trademark episodic voice-over, Meredith Grey then tells a "lame joke" about a patient who says, "Hey doc, it hurts when I go like this." The doctor replies, "Well, don't go like this," and, despite the joke's lameness, "it is nonetheless true that as human beings, we cannot help but want to follow our own instincts, guts, and primal urges no matter how much it hurts."

The next scene depicts Alex Karev (Chambers) sending letters to Jo Karev (Camilla Luddington), Miranda Bailey (Chandra Wilson), and Meredith Grey (Pompeo). Alex (Chambers) delivers a voice-over of his written letters as the three begin to read them, stating that he is not leaving but has already left—he is gone.

The episode then takes an overview backward to key plot points in the series that are essential to Alex's overall journey, from his arrogant, snarky early seasons to his development as a successful pediatric surgeon, and to Izzie and subsequently Jo's loyal friend and partner. Flashbacks of his romance with Izzie, including their wedding and her fight against cancer, are also seen.

Additionally, it features recollections of the friendship between the original five interns and Meredith's developing bond with Alex throughout the sixteen seasons. Alex tells Meredith that he doesn't want to say farewell in the form of a letter. It brings back memories of Alex having to confront his issues instead of escaping them when he tells Meredith that she was always the one to correct him. Then Alex explains that since the one right thing isn't in Seattle, he doesn't want to be corrected or have Meredith say the proper thing. Then, Alex confesses that he is with Izzie.

Flashbacks to Alex and Izzie's early connection are shown after this revelation. As the story progresses, Alex discloses that he got in touch with Izzie during Meredith's trial to obtain a reference letter for her medical license. He acknowledges that the trial provided him with a reason to get in touch with Izzie and find out if she was still alive. Alex claims that after a brief phone conversation, he heard small sounds in the background and asked Izzie if she had children. After a moment of silence, she disclosed that she did. As it happens, those are his kids.

Alex states that Izzie was unmarried and desired children, but she was unable to conceive biological children due to cancer nuking her eggs, but she did have their embryos. Scenes involving Alex and Izzie that center on the embryos are shown in flashbacks from the fifth season. As a flashback of Alex's concerns about her surviving cancer is revealed, Alex reveals that he was too scared to care what she did with them, so he signed documents off so she could do whatever she wanted with them.

He admits that he should have told Jo and Meredith, but he chose to go to visit his kids after completing the trial. He lives on a farm in the middle of nowhere in Kansas, and his twins, Alexis and Eli, are characterized as "hilarious and stubborn" like Izzie. Alexis has Izzie's eyes, and Eli's smile is crooked like his. The children aspire to be doctors, and they bake like Izzie. He also discloses that Izzie has grown significantly and is a surgical oncologist. Alex repeats that she could come up and take him back to Seattle, but he hopes she doesn't and emphasizes that this is the first time he's ever been in his proper place. Alex says he's hoping she'll come up and see his kids when she's ready and not angry.

As Jo reads her letter from Alex, flashbacks also briefly depict her journey and her relationship with Alex. Besides expressing his sincere regret, Alex admits that he also has feelings for Izzie. While acknowledging that Jo has deserved so much more and that the letter is the worst thing he has ever done, Alex also talks about the kids he has with her.

Alex tells Jo that he felt as though he and Izzie were stuck in time, talking as though no time had gone, and that they had unresolved business. According to Alex, he must offer the kids the life that he and Jo were never able to have. Alex visited a lawyer, signed divorce papers, and gave her his Grey Sloan shares.

At an AA meeting, Webber compares Alex's situation with Jo and Izzie to that of Ellis and Adele. He says he wishes he could have seen Maggie Pierce (Kelly McCreary) grow up so he can't be angry with him no matter how hard he tries, but he acknowledges his resentment that he was unable to say goodbye just because he was a teacher. Finally, it shows another scene of Izzie and Alex's connection, this time through Izzie's declarations of love and the similarities between her and her children.

Bailey discusses Joey with Ben (Jason George) and connects the circumstance to Alex's childhood. As Jo reads the letter and Link (Chris Carmack) refers to her as his hero, she suppresses her feelings and chooses to carry on working.

As the episode comes to a close, Meredith is speaking to her daughter Zola (Aniela Gumbs) and getting ready to convey to her that Uncle Alex has left. Meredith's voiceover states that there isn't a suitable way to say goodbye.

Related: Who is Dr. Bailey on greys Anatomy

Why did Alex Karev leave Grey’s Anatomy?

Justin Chambers who portrayed Dr. Alex Karev in the American medical drama series Grey’s Anatomy left the show to pursue diverse acting roles and career choices. Fans and critics gave mixed reactions, with some disagreeing with how the show handled Alex's departure, but most thought it made sense considering the circumstances behind Chambers' sudden departure.

Alex’s final appearance on the show was on the 8th episode of season 16 titled, “My Shot” which aired on November 14, 2019, on ABC.