Grey's Anatomy: 20 Things Wrong With Alex Karev We All Choose To Ignore

Grey’s Anatomy has featured a character with every type of attribute TV has to offer. We’ve got the good guys, the antagonists, the dreamy boys, the backstabbers, the tough ones, and the bad boys. The most popular tend to be either the dreamy ones i.e. McDreamy, or the bad boys such as Mark Sloan and Alex Karev.

The show plays into the old trope of turning the initial bad boy into someone with a much gentler disposition. Alex Karev has seen his fair share of mellowing down over the last fifteen years we’ve followed him, but there’s still a lot left to mature in this guy. One of the defining aspects of his character is how flawed he is. There’s a definite element of self-righteousness to him as he’s never been the one to blend in a normal crowd because things like making small talk are something Karev can never indulge in. He’s stuck to feeling like a victim of the way the world works and refuses to partake in societal customs, preferring the company of a select few who truly get him like Meredith.

It’s still a fascinating character to follow because you wouldn’t have expected him to have lasted this long upon his initial introduction. At first, he seemed to mainly be a foil to George O’ Malley, but since then Alex has become a standout character in his own right. But there’s no looking past the aspects of him that aren’t the best of him. If you think he’s the best, then looking through this list might convince you otherwise.

Here are 20 Things Wrong With Alex Karev.

20 He Doesn't Have A Great Personality

Of all the characters on the show, Alex is definitely the least approachable. While people such as George or Izzie were the kind you wanted to approach and could feel comfortable around, Alex is nothing like that. It’s hard to tolerate him for the most part as Karev is hardly ever in a giving mood.

He doesn’t like to put up with people in general and isn’t willing to be humble or a shoulder to cry on. He can be like this to people like Meredith, but it took about a decade before he and Meredith could be like that. For the most part, Alex’s personality isn’t the best.

19 He used Lexie to get over Izzie

Chyler Leigh as Lexie Grey in Grey's Anatomy

Okay, if you think about it, everyone on the show is pretty flaky, and Lexie is around the top of the bunch, but Alex did still use her to make himself feel better for losing Izzie. He’d sort of used her in Season 4 as well when Lexie was just too eager to get a Resident-Boyfriend.

By Season 6, though, she was likely hoping for more from Alex, who never really took her seriously and admitted while in shock, after getting hurt, that he loved Izzie. Once he’d broken up with her, Alex never felt bad about stringing Lexie around either.

18 His Original Relationship With Jo

Camilla Luddington and Justin Chambers as Jo Wilson and Alex Karev in Grey's Anatomy

Alex and Jo were always headed toward a romantic relationship during Season 9, but attempts were made to make it look like this might not be the case. They hung out, talked about casual stuff, and didn’t show too much romantic interest in one another. While this strategy wasn’t too bad, the writers shouldn’t have had a scene where Jo even called Alex “like my brother”.

In retrospect, that remark doesn’t age well, nor does it look too good either, unless the show wants to convince us a sibling-like relationship can turn into a romantic one between friends.

17 he still loves izzie

Alex may not be completely in love with Izzie anymore, but there’s no denying he still has a place for her in his heart. Throughout the first six seasons, she was his main love interest. Her influence was such that Alex was still hungover Izzie as late as in Season 12, when she’d been gone years.

To this day, as recently as the 300th episode, Alex keeps mentioning her from time to time. In the most recent instance, Alex revealed he had made up a scenario where Izzie might be today. If that doesn’t tell you he’s been thinking about her all these years nothing will.

16 His relationship with Jane Doe

During a break between his pursuit of Izzie from Season 3 to Season 4, Alex had a much-maligned storyline with a woman initially only known as Jane Doe. This seemed to be heading toward a sweet Doctor-Patient love story until it became completely messed up.

Out of nowhere, she had a husband, and Alex was in a weird triangle of sorts. To make matters worse, in Season 4 the woman had several mental health problems and was then written out inexplicably. The relationship was barely ever mentioned after that.

15 How he treated George

Despite whatever he’s done over the years, both good and bad, the worst part about Alex is how he treated George. For reasons never explained, Alex hated George with a passion, who never did anything to warrant such behavior against him.

Alex regularly insulted George, treated him like garbage, and belittled him at every turn. What’s worse is that Alex did it in such a way that he felt it was justified. It was classic bullying, but Karev was adamant in his hatred for George right until the latter’s end. He wasn’t even much sad when George passed away, being mainly concerned over how Izzie felt.

14 The Callie Retcon

A few years earlier, Grey’s Anatomy’s ratings fell hard from what they had once been. In order to regain that interest, the show had several gimmick episodes that were out of the box. One of them was a flashback episode that showed the doctors in their initial days in the hospital.

A big retcon was there in the form of Karev and Callie Torres having a one-time thing upon their first meeting. This had nothing to do with anything so it was a surprise the show handed us a factoid about the two. Not only did it make no sense, but it also made Alex look like an even bigger hound than he is.

13 He And Mark Are Similar

Speaking of being a hound, the man with this title was Mark Sloan, who didn’t go two episodes without being with a new girl. Mark was stuck with this tag throughout his tenure and it became a defining character trait of his, but he’s not the only one always around the ladies.

Alex also has a very long list of women he has been with. For starters, the names that pop right up are Izzie, Addison, Callie, Lexie, Jo, and all of these women are the main characters we’ve seen. These women aren’t even a quarter of the ladies we’ve seen Alex with! Poor Mark gets flack for no reason.

12 He gets crazy jealous

There are several indications in Grey’s Anatomy that Alex and Jo’s relationship isn’t exactly healthy. They both have messed up, even traumatic, pasts before they came across each other and every personal problem has affected their relationship. One of the side effects of enduring his past problems has been Alex’s jealousy.

No matter where he is with Jo, whether with or without her, he finds someone to be jealous of connected to her. This was played off as cute in Season 9 when they hadn’t gotten together but since then the jealousy related incidents don’t come across half as lovey-dovey as they used to.

11 Hurting Addison

Addison Montgomery Private Practice

Another person he didn’t show regard for was Addison. In Season 3, when both Addison and Alex weren’t involved in any storylines, the two were randomly matched together. For some reason, it worked great and could’ve become a superb storyline as these two had something that just seemed right. Unfortunately, it wasn’t to be and Alex very offhandedly turned Addison’s attempts of taking it further down.

In the end, Alex basically took advantage of the situation to have some fun and felt no remorse when Addison bailed from the hospital. It worked out for her as she went onto Private Practice, but let’s not forget how little care he showed.

10 Not Respecting Meredith's Request

When it comes to choosing between women and his friends, it looks like there’s no point of discussion for Alex. In Season 4, when he and Meredith had been friends for about three years, she asked Alex to lay off Lexie; she being Meredith’s estranged sister and all.

At first, it looked like Alex would honor this request, but it wasn’t long before he and Lexie became an item. Upon Meredith calling him out on this, Alex showed no guilt and instead accused Meredith of hating on Lexie irrationally and blaming Alex for it. While he was right about that, that still doesn’t change the fact that Alex didn’t honor Meredith’s initial request.

9 The Disappeared Debt

Part of Shonda Rhimes’ attempts to discredit Izzie further due to Katherine Heigl’s impending contentious departure was having her abandon Alex and leaving him with mountains of debts to cover. These were the payments for her treatment, something that seemed to mountainous for Alex to pay off. This was building up toward a more grown-up problem to tackle and was an interesting light to see Alex in.

However, the storyline was abandoned in the coming episodes once Izzie left officially. Suddenly, Alex wasn’t burdened by the debt and seemed to have paid it off. However, judging by how he worried he had been, it doesn’t seem likely he had the funds to do so.

8 He Didn't Get Fired (For Some Reason)


The hospital Alex works at seems to have outlandish levels of leniency toward its employees. For instance, Izzie met no repercussions in Denny’s LVAD case even though it was something she should have gone to jail for.

A little less significantly, Alex also partook in a highly unethical relationship with a patient. The Jane Doe patient was supposed to be admitted at Seattle Grace when Alex began his relationship with her. However, everyone knew of this and Alex never faced any threats of dismissal. He was both her boyfriend and her doctor. Realistically, the thing should have never begun seeing that it was against the rules.

7 He's A Hypocrite

How many times have we seen Alex Karev lose it in front of people for not dealing with their issues? Every few episodes there seems to be at least one occasion where Alex bursts out in someone’s face for struggling with a problem that really isn’t one, or for that person to be behaving in a self-righteous way.

It works both ways though as Alex himself has a bunch of problems he refuses to deal with. For instance, in Season 9 he was struggling with guilt at leaving the hospital by engaging in one-offs with a number of interns. He was in a relationship with a married woman, but looked down upon George for being unfaithful to his wife.

6 Hiding His Feelings

Here we have a guy who just might be the king of hiding his feelings. Most of Alex’s problems come from him not being open about his feelings and confronting the issue when it’s not such a big deal. He let all of his problems with Jo carry on without really talking about them until some big blowout caused a fracture between the two.

Earlier on, he would never talk about his feelings with Izzie, something that caused her to go and find solace with Denny. In actuality, Alex wants to be loved, but does such a terrible job at conveying it that it gets lost on most people.

5 Nothing Like The Actor

Unlike all of Alex’s hound-like tendencies we’ve talked about, his actor is nothing like that. In fact, Justin Chambers is way older than the character he’s portraying. Justin’s been married to the same woman for twenty-five years by now and has five children. He’s also forty-eight years-old by now, having started his portrayal when he was thirty-five.

Meanwhile, Alex was supposed to be around twenty-seven in Season 1 and is only now entering his forties. Alex is supposed to be much younger than someone like Mark Sloan but in reality, it is Justin Chambers who is two years older than Eric Dane!

4 He Wasn't Originally Written In The Show

Apart from Meredith, Alex is the only intern left from the first episode. He’s also one of a handful of cast members who’s been there from the start. However, Alex technically wasn’t an original intern. The show began with the same character sans Alex. Upon production of the pilot, it was felt that a character was missing from the group dynamic and as such Alex was created.

You might not have noticed but Alex’s scenes in the first episode are all digitally inserted to make it appear as if he’s among the group of people. In reality, these scenes were shot separately from the original scenes and then spliced together.

3 His List Of Conquests

A weird accomplishment for Karev in his inadvertent pursuit of women is this: he’s been with a woman from every stage of education. When he was an intern he was still involved women as far ahead as attendings, while when he himself became an attending he was with women who were barely interns.

To sum up, Alex has been with at least one woman from med school, internship, residency, fellowship, and attending. If that doesn’t make your eyes widen then probably anything will. This ‘accomplishment’ is likely just a coincidence by the writers, but when you look at it this way you might just wonder what’s the deal with Alex really.

2 The way he treated April

April was rather insufferable upon her introduction. She was too competitive and not-so-friendly in initial characterization. April’s character wasn’t consistent either as she was pretty willing to let Alex be her first time while later on just the idea of being close to a man was something she wasn’t willing to consider.

Regardless of all that, Alex looked to use her to make himself feel better and when the time seemed right for it he made his move. However, he was far too aggressive and didn’t care at all how she felt emotionally, eventually shouting at her before things could progress. This traumatized April to some degree.

1 He loses his temper a lot

From the get-go, we’ve seen Alex be more physical in his demeanor than anyone else. Whenever he speaks to a person he makes sure to get in their face so as to intimidate them. He doesn’t classify between men and women in this regard and is fine with being aggressive when talking.

But it doesn’t just stop there as we’ve seen Alex come to blows with a number of men over the years. It’s not difficult to get him to start fighting, which isn’t the best quality. Alex blows his top off in minute instances too as his tolerance rate for people isn’t high. He has a tendency for violence along with his aggression.


Is there anything else wrong with Alex from Grey's Anatomy? Let us know in the comments!

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