|Grey's Anatomy character|
|First appearance||"A Hard Day's Night"
1x01, March 27, 2005
|Created by||Shonda Rhimes|
|Portrayed by||Justin Chambers|
|Full name||Alexander Michael Karev|
Dr. Junior Butthole
Dr. Douche Face
|Aliases||Alexander Michael Evans|
|Occupation||Attending pediatric surgeon|
|Family||Aaron Karev (brother)
Amber Karev (sister)
Helen Karev (mother)
Jimmy Evans (father, deceased)
Nicky Evans (half-brother)
|Spouse(s)||Izzie Stevens (divorced)|
|Significant other(s)||Olivia Harper
Rebecca "Ava" Pope
|Relatives||Naomi Evans (stepmother)|
Alexander "Alex" Michael Karev, M.D. is a fictional character on the ABC television series Grey's Anatomy, portrayed by actor Justin Chambers. Introduced as a surgical intern at the fictional Seattle Grace Hospital, Karev eventually obtained the position of resident, later becoming a pediatric surgical fellow. His relationships with colleagues Meredith Grey (Ellen Pompeo), Cristina Yang (Sandra Oh), Izzie Stevens (Katherine Heigl), and George O'Malley (T. R. Knight) formed a focal point of the series.
The character is initially disliked by his fellow interns, and is often accused of being brusque and dismissive with his patients and co-workers. As a resident, Karev's negative attitude, temper and rudeness has occasionally earned the ire of the attendings, with former neonatal surgeon Addison Montgomery requesting him on her service as punishment for his rudeness to her and neurosurgeon Derek Shepherd, amongst others, throwing him out of their service for his inappropriate comments about patients. He demonstrates profound skill for the specialty which prompts praise from Montgomery and contributes to Karev's interest in pediatric surgery for the rest of the series. As the character developed, he displayed more empathy for patients and is shown to have a gift for connecting with young children, despite his repeated claims to dislike them.
Although Karev and Stevens had an on-off romantic history in previous seasons, it was not until the fifth season that the two formed a lasting relationship. Despite Stevens' advanced skin cancer, the two marry. Justin Chambers commented on his character's inability to tell Stevens that he loves her in the beginning of their relationship, saying that Karev has difficulty expressing himself. Though Stevens leaves the hospital (and the show) in season 6, series creator Shonda Rhimes has said that she would like the chance to create closure for both Karev and Stevens.
His mother had a mental illness, and his father was often absent, as well as often becoming violent towards Alex and his mother. Alex began wrestling in high school, and eventually physically confronted his father - after this, his father did not return. Alex has a younger brother, Aaron, and a younger sister, Amber; they were all placed in foster care for 5 years. Though Aaron and Amber only had a few foster families, Alex went through 17 foster families in 5 years before he reunited with his siblings. It is revealed in later seasons that Aaron was diagnosed with schizophrenia and tried to kill Amber. Alex was present when Aaron had to be committed to a psychiatric ward.
Alex secured a position in the surgical residency program at Seattle Grace Hospital after graduating from the University of Iowa. He initially makes a poor impression on his fellow interns meeting fellow interns Meredith Grey (Ellen Pompeo), Cristina Yang (Sandra Oh), George O'Malley (T.R. Knight), and Izzie Stevens (Katherine Heigl) whom he later taunts when he discovers she used to be a lingerie model. After initial disagreements, Alex reveals to Izzie that his father was a heroin addict who used to beat his mother. He became a wrestler so he could defend his mother, and attended university on a wrestling scholarship. He and Izzie begin a friendship. At the end of the first season, George contracts syphilis from Alex through nurse Olivia Harper, causing animosity between the two.
Alex asks Izzie out on a date, but he is thrown by the news that he has failed his medical board exams. Izzie is offended since he pays no attention to her during their date and so informs him that she no longer wants to go out with him. He later freezes during an emergency operation, needing George to take over from him. Alex's relationship with Izzie is damaged when he experiences erectile dysfunction with her. He goes on to sleep with Olivia again, and is caught by Izzie and they break up. After retaking his exams, Alex manages a pass, and reunites with Izzie after a bomb scare in the hospital. They break up again, however, when Izzie falls for cardiothoracic patient Denny Duquette.
Alex helps Izzie recover from Denny's death and advances Izzie but Izzie backs away since she is still in the process of getting over her loss and they remain friends. Alex spends a period of time working under neonatal surgeon Dr. Addison Montgomery (Kate Walsh), and though he is later released to work for plastic surgeon Dr. Mark Sloan (Eric Dane), he finds his interest returning to Addison's firm. Addison is attracted to Alex, and the two share a kiss and later sleep together. In the aftermath of a ferry accident, Alex rescues a pregnant woman (Elizabeth Reaser) who awakes with amnesia, and grows close to Alex as he helps her forging an identity for herself, picking out the name Ava. After she gives birth to her daughter, Ava's memory eventually returns, although she tries to hide it from Alex as she had recently left a bad marriage. He convinces her to tell him her true identity, and she reveals herself to be Rebecca Pope. Alex turns her down after realizing she's married, feeling that he is not good enough for her.
Rebecca returns and she and Alex sleep together before she goes back to her husband. Alex has a brief relationship with intern Lexie Grey (Chyler Leigh), but chooses to be with Rebecca when she returns and tells him she is pregnant. After Rebecca attempted suicide, Izzie convinces Alex to admit her for psychiatric help due to Rebecca's hallucinations of her pregnancy. Alex later breaks down in Izzie arms, and the two kiss.
Later in their relationship, Izzie begins hallucinating about Denny, and uncovers the fact she has metastatic melanoma (Stage IV) with an estimated chance of 5% survival. It is revealed that Izzie's hallucinations of Denny are, in fact, caused by her tumor. Alex is shocked by the news, but finds the strength to stay by her side. Izzie plans a wedding for Meredith and Derek, but when Derek finds Izzie has another inoperable tumor in her brain, they give the wedding to Izzie and Alex, who marry in front of all their friends. Izzie debates whether or not she should undergo a risky surgery to remove her tumor and Alex supports her, but eventually insists that she should have the surgery. Alex performs CPR on Izzie after she flatlines.
Izzie regains a heartbeat but is soon fired leaving Alex a Dear John letter and no clue as to her whereabouts. She later returns to the hospital and says to Alex, thinking he had a hand in getting her fired, that she could not forgive him for talking to the Chief. Alex says he could not forgive her either for not giving him the benefit of the doubt and leaving without talking to him first. Alex re-kindles an old flame with Lexie. Alex seems to have recently found that his calling is actually Peds and not Plastics as he had decided in the earlier seasons. Seeing Alex's ability to handle child patients, Dr. Arizona Robbins shows an interest in mentoring him for that specialization. Alex's brother Aaron comes to Seattle Grace for surgery, and lots of painful memories resurface because of this. Meredith discovers Alex, along with Aaron and their sister Amber, had been in foster care for five years when their mother could not take care of them. Alex is also served with divorce papers from Izzie. Alex is shot in the hospital by a deceased patient's husband, but survives with the help of Lexie and Mark. While undergoing treatment, he mistakes Lexie for Izzie.
Following the shooting, Lexie has a mental breakdown in front of Alex and he walks away. Dr. Bailey bars Alex from surgery until he has the bullet removed, which he later allows her to do. Alex realizes that his passion lies in Pediatric Surgery. He is further shown to be excellent with children, comforting with a young patient while growing her a new trachea. He immediately gets on the wrong side of new Pediatric attending Stark while Arizona is on leave Alex then attempts to sleep with virgin April Kepner after visiting his mom in Iowa when his brother was diagnosed schizophrenia. Alex and Meredith perform an emergent surgery on a young boy by themselves during the night shift, dealing with the angry fallout from Stark (who would not answer his pager) but gaining the wordless approval of the Chief. Alex is thrilled when Arizona returns from Africa and hopes she will come to work for the hospital again. In the meantime, Alex falls for the new OBGYN attending, Lucy Fields, and they start a relationship after she kisses him. Alex finds out about Meredith sabotaging her Alzheimer's clinical trial and rats her out in attempt to get Chief Resident.
The adoption counselor takes away Zola, the child Meredith wanted to adopt. Realizing his mistake, Alex apologizes to Meredith who forgives him shortly after. As the end of the fifth year of residency is near, the surgical residents, including Alex, prepare for their board exams for the different fellowships they plan on joining. Though Alex is late for his exam because he had to treat a patient, he ends up passing. Dr. Webber tells him that Johns Hopkins Hospital, which has the top program in the country, has been very impressed with him and has decided to create a position in pediatrics surgery for him and accepts the position. After finding out his decision, his current boss, Dr. Arizona Robbins, yells at him and takes his place on a plane that later crashes.
Following the rescue of his colleagues, Robbins' health deteriorates and amputates her leg. He extends his stay at Seattle Grace until a replacement for Robbins is found, but when he learns that the replacement will send the exchange program to UCLA, he decides not to leave. Karev forms a friendship with new intern, Jo Wilson that eventually develops into romantic feelings towards each other. Alex admits his love for Jo, and the two kiss and become a couple.
Alex's estranged father, Jimmy, who he hasn't seen in 18 years, is admitted to the ER as a patient. After being discharged, Jimmy plays with his band at a bar, and Alex spends several nights watching his father perform onstage. Unknowing that Alex is his son, Jimmy confides in Alex that he had another family that he hasn't seen in years. This made Alex upset and he punched Jimmy at the bar. Once returning home, Alex unleashes his hurt and anger on Jo for having encouraged him to reconnect with his father. His father returns suffering from symptoms of withdrawal and hallucinations of the past where more is revealed about Alex's childhood. Jimmy tells Alex he knows that he is his son and Alex yells at his dad stating that "I WAS THE DAD". His dad later goes into cardiac arrest and is brought into surgery, fate unknown. Alex kisses Jo at April's wedding wanting to start a family with her. That night his dad died, due to a mistake by intern, Shane Ross, and Alex is upset. He punches Ross and is later comforted by Meredith.
Upon the completion of his fellowship in Pediatric Surgery, Alex is given an offer to work at Dr. Oliver Lebackes' private practice office, claiming that he will have more flexible hours and "a big fat paycheck". Alex takes this offer happily. Robbins is initially angered by this decision and thinks that Alex is choosing money over substance. Eventually she realizes that he has become a wonderful surgeon and that she is happy to see him go. He later discovers that he isn't happy working at the private practice and expresses a desire to return full-time to Grey Sloan. At the end of the season when Cristina leaves, she leaves Alex her share of the board, including her seat.
In Season 11, Alex is fired by Dr. Lebackes when Maggie Pierce accidentally reveals to him that Karev was thinking about leaving the job. Webber recommended Bailey to fill Yang's board seat after she left, so Bailey and Alex fight over the chair. They both make presentations to the board and eventually Bailey wins, with a unanimous vote in her favor. He is hired back as an attending Peds surgeon and takes over full-time as Arizona pursues a fellowship with Dr. Herman. Alex continues to date Jo and his friendship with Meredith grows stronger than ever, with him taking on the role of her new person. When Derek dies and Meredith runs away, Alex is upset by her leaving without telling him where she went and calls her everyday. Eventually she calls him, tells him she is okay, and to stop calling. When she goes into labor and gives birth to Ellis Shepherd, Alex goes to see her since he is her emergency contact. He brings Meredith and her kids back to her house. She asks to move back in with him in her old house. Alex sells Meredith back the house and he and Jo rent a loft.
Casting and creation
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The American Broadcasting Company (ABC) characterized Karev as "honest", "always tells it like it is", while also citing his mouth, his punctuality and him being a "smart-ass" as his weaknesses. Shonda Rhimes said of Karev: "I love that we have a character who can do something wonderful but still be a selfish cranky ass about it. Alex gets to be complex in ways most characters don't because even though he’s got a moral code, his moral code is totally twisted and dark. But he's essentially good – deep down inside." Carolina Paiz, one of the writers of the series, wrote: "He has so much going on inside... you think you've got him figured out but then he just reveals this whole other side to him."
"He is superficial sleazeball who turns out to be a nice guy and a talented doctor with an amazing bedside manner, as well as the budding love interest of Katherine Heigl's character Isobel." DVD Verdict wrote of the character's development in the fourth season: "Love him, hate him, or both, Karev speaks his mind, rough edges and all. But ultimately his cold heart seems to be softened by his blossoming relationship with Jane Doe/Ava/Rebecca." Rhimes felt that the 100th episode during which Karev marries Stevens showed how he had grown up: "Look at him. Standing at the altar and saying those vows like a man. (...) He's become a man who can step up. And I love him for it."
Analyzing Alex Karev, Rachel Simon called him "underrated;" she pointed out that Alex’s personal growth never seems to get acknowledged, as "Alex begins Grey’s as an arrogant, obnoxious intern who pushes away anyone who tries to care about him. He breaks Izzie’s heart 1,000 times, and then acts surprised when she falls for someone else. He sleeps with any girl who will have him, insults everyone who doesn’t, and generally enjoys being the hospital asshole. Yet, over the course of 10 seasons Alex has evolved, slowly and realistically, into a genuinely good person whose faults don’t miraculously disappear, but take a backseat to much better qualities."
Former television columnist for The Star-Ledger Alan Sepinwall disapproved of Karev's flirt with Addison as "he should take interest in a woman's speciality and respect his boss without getting in her pants." Reviewing the fifth season, Chris Monfette of IGN wrote: "Alex, who'd become simply the cast's angry outcast, was uplifted as his relationship with Izzie became more and more substantial, and his bedside scenes with her toward the end were some of his character's best material yet."
On his career path as a Pediatric Surgeon Examiner wrote, "Despite his rough exterior, Alex has a certain child-like innocence and need for acceptance. He is keen in recognizing these traits in kids, as well. He reaches out to kids on many levels." and added, "Alex has major trust issues. Maybe it was the constant beatings from his father. Or, his mother’s mental illness. Or, being shuffled through 17 foster homes over a 5 year period. Who wouldn’t have issues with a childhood like that?"
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