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Why Did Karev Leave Jo For Izzie? 'Grey's Anatomy' Fans May Never Understand

Grey's Anatomy is known for its plot twists. The medical drama has been able to keep viewers engaged for 16 seasons by creating juicy storylines that fans could never see coming. Welp, in most recent news, the series might've just thrown in one of the most controversial twists in its history, in explaining what happened to Alex Karev, who has been absent from episodes since the end of 2019. Fans now know Karev left Jo for Izzie, but why? Grey's Anatomy fans have a lot to wrap their heads around.

On the March 5 episode of Grey's, Karev's storyline finally came to a close. But since actor Justin Chambers had already made his final appearance on the show in 2019, there weren't any big scenes with him in store for this episode. Instead, Alex Karev was heard, rather than seen, as he narrated various handwritten letters he sent to his friends and wife at Grey Sloan Memorial Hospital, saying goodbye and explaining where he went. Flashbacks from past seasons accompanied his voice and helped viewers reminisce on everything he left behind.

While some viewers are at ease now that they know what happened to Karev, most are shocked by Karev's decision to leave his wife Jo for his ex Izzie. Karev explained in his letter to Meredith that he'd reconnected with Izzie when he was helping Meredith get her medical license back. Although he said he'd always been curious about how his ex-wife ended up, it wasn't until then that he decided to contact her. And when he called, he heard a child's voice on the line.

In the plot twist of the century, the kids — yes kids, as in plural — on the other end of the phone were his. The five-year-old twins, Alex and Eli, came from the embryos Izzie froze eons ago (and Jo found out about in Season 12). Apparently, Izzie finally used those embryos and was raising the children on a farm in Kansas. Karev explained in his letter to Meredith that his children played a huge part in his decision to leave Seattle and, more heartbreakingly, Jo: “I love Jo. Deeply. Still. I think I always will. And if it was just about two women I love, I’d choose my wife. You know I would," he wrote. But that just wasn't the case.

As for Jo's farewell letter? Alex recognized leaving her for Izzie without warning isn't his most noble act. “It’s officially the worst thing I’ve ever done,” he told her, while explaining he didn't want to miss any more of his kids' lives, and he couldn't look her in the eyes to tell her this news in person. To slightly make up for it, he left her with his shares in Grey-Sloan... but also with divorce papers, which he'd already signed.

Jo handled this gutting news like the boss she is: She closed the letter and started getting ready for her shift at the hospital, just like it was any ordinary day. Link, who was looking on as this all went down told her, “You’re my hero," to which Jo responded: “Mine, too.”

The now-Karev-less Season 16 of Grey's Anatomy continues on Thursdays at 9 p.m. ET on ABC.