'Grey's Anatomy' recap: E-I-E-I-WHOA! Karev's surprise storyline revealed (2024)

It’s the episode you’ve been waiting for. Through a series of old school letters written on notebook paper, mailed at an actual post office, we finally learn where Alex Karev has been hiding.

He’s on a farm. In Kansas. With Izzie.

I did NOT see that coming. Do you know what else I didn’t see coming? HE HAS CHILDREN. Izzie used their embryos from way back when she had cancer and birthed twins without Alex even knowing it was happening. Karev is a father and I’m undone.

Everyone breathe. In through the nose. Out the mouth.

Meredith’s Letter

Flashbacks help us maneuver down Memory Lane from the last 16 years. There’s baby Meredith and baby Karev! Young Cristina, George, Izzie are all stumbling over each other to impress rock star Dr. Bailey who hasn’t changed a bit. Is that McDreamy I see in the distance?

Showrunners use these nostalgic images to ease the blow when we hear through Alex’s voiceover that he is gone. And he’s not coming back. He knows that if he told Meredith in person, she would try to talk him out of it. He just can’t face her. It’s not about Seattle, or Jo, or the hospital. He’s left everything to be with Izzie. Cue the video montage. Don’t forget that iconic kiss at the bar. Thank you.

It seems Alex called Izzie and asked her to write a letter on Meredith’s behalf for her trial. This was the perfect excuse for him to finally reach out to his one true love after all these years. Everything clicked over the phone as if no time had passed. When Alex heard kids in the background, Izzie noted that she is a mother and oh, by the way, Alex is her babies’ daddy. He leaves immediately to meet the family.

Alex reminisces about how first Cristina was Meredith’s person. Then he stepped into that role. But he wants Meredith to know that she’s always been her own damn person. He begs her not to hate him, the Evil Spawn.

So does this mean Meredith doesn’t get a new person?

Jo’s Letter

Of course, Alex starts Jo’s letter by admitting that up and leaving her was the worst thing he’s ever done. He follows that truth with another: “I’m in love with Izzie.”

Jo spills all the tears, which is heartbreaking because her video montage is all about her strength and bravery. Then he drops the kid bomb. More tears. Pulling from both of their tumultuous pasts, Alex lays the groundwork for Jo to remember how hard it was growing up without a family. He doesn’t want to do that to his own kids and he knows that she would agree with him.

He understands that getting everything he wants hurts Jo in the process, which is a nice thing to hear because I was wondering if he knew his words were cutting her heart. Then he writes that he can’t face her because he knows he wouldn’t be able to walk away. Therefore, he’s attached divorce papers (she gets everything) and all his shares in Grey Sloan.

Jo deserved better than this. I hope she goes day drinking with Link. And then they start dating.

Bailey’s Letter

Alex thanks Bailey for pushing him and helping him grow and literally taking a bullet out of his stomach. She’s the reason why he is a successful surgeon and he loves the fact that she trusted him with all her secrets. He signs off, “I love you, Dr. Bailey.”

Bailey is shocked like the rest of us and when Ben walks in from work, she breaks the news that Karev is gone. This sparks a fire in Bailey and she monologs that it’s a matter of grace and luck that Alex is who he is today. A man, father, and a fine surgeon by chance. She doesn’t want that for Joey. Ben agrees, just like that, and they both promise to consult each other before making life-altering decisions in the future.

Congratulations! It’s a boy! A full-grown boy!

Richard’s Letter

We don’t hear Alex’s voiceover narrate Richard’s letter. Instead, Richard argues out loud at an AA meeting about how one of his former students made a mistake. He softens when he considers Alex loving two women. Richard certainly understands the logistics of loving multiple people. He can’t fault Alex for that.

Moreover, he also understands the feeling of not seeing your own kid as a child. Hello Maggie! Alex deserves to know his own children. Was it really a mistake for Alex to leave? Other than Jo’s heart spilled all over the doctor’s lounge?

Richard is sad. He’s sad that he didn’t get to say goodbye to his friend. And he’s sad that another person in his life has left suddenly. When will it stop?

The episode ends with a glorious montage of Izzie and Alex’s love story. I watched it twice. Who remembers when he picked her up in that fabulous pink dress after Denny Duquette dies? Come on. Classic Grey’s Anatomy.

It almost makes me forget that Jo is stoic, prepping for surgery, refusing to break down at the loss of her husband.

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