We recently saw an episode of Grey's Anatomy where we said goodbye to Alex Karev, and fans were not happy with the outcome. He ended up writing letters to several of his colleagues, and even his wife, letting them all know he had run away with Izzie Stevens. It turns out that she had birthed their two children and he was now happily living in the countryside with his new family.

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Fans felt it was a stab in the back to Joe, his wife, as she didn't deserve to be left in this manner and Karev was a better man than that. There have been several recommendations for other ways in which he could have left, and we have decided to list a few. Keep reading to learn about 10 other ways Alex Karev could have left the show!

An Emotional Death

Meredith lying with Derek in the hospital on Grey's Anatomy

The most common answer for removing characters from the series is an emotional and dramatic death. He could have been hit by a car, fell from a building, or so many other absurd things could have happened.

This is what fans had expected would happen when it was announced that he would not be making a return to the series, and many still wish it would have ended in this way. It would have broken our hearts, but at least he wouldn't have been a jerk to Joe in a simple letter.

Left For Switzerland

Cristina Yang looking concerned on Grey's Anatomy

Karev could easily have left for Switzerland to aid Dr. Cristina Yang after his hospital was closed down. Fans could have accepted this as Joe had every right to go with him, and it would help explain his lack of contact.

Yang runs such a huge operation overseas that more bodies would always be a welcome sight where she is working. Karev could have continued to research procedures and tools to help his pediatric patients while working closely with a mind as excellent as Yang's.

Care For His Mother

It is no secret that his mother has had her fair share of issues in the past, as her illness helped to shape Karev's future. We could understand if he left once again to care for her, and Joe would have understood and possibly even moved with him.

Fans knew his mother was doing better as she was rejoining the workforce and working with a medical team, but this was not the direction the writers decided to take. Karev had a big heart that would have done anything for his family, but in the end, it wasn't enough for him to stay with Joe.

Police Classify Him As A Missing Person

Karev could have simply disappeared without another word a trace as police classify him as a missing person. It would leave everyone in the dark, as we all wonder what could have happened to him, but it would be better than the ending they gave us.

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Joe would eventually have to move on as no information is found on his whereabouts. It could have been as simple as a walk in the park that went wrong or a quick trip to the corner store that ended in him being gone forever. Fans didn't need a whole explanation, although, some hope that he might one day return was better than nothing.

Joined The Military

Kevin McKidd and Bridget Regan as Owen and Megan Hunt in Greys Anatomy

It doesn't really fit with Karev's persona, but then again, running off with Izzie didn't either. He could have simply joined the military after his position was vanquished at the other hospital. It would have left the door wide open and it would explain why he was never in the show as he was deployed overseas.

They could have eventually killed him or created a falling out between him and Joe as he revealed his true calling was to never come back home. It would have been heartbreaking, although, we wouldn't have been left with an Izzie-sized stain on his image.

Accepted A New Job

We know from earlier seasons that Karev was faced with the decision to take a fellowship at John Hopkins Hospital across the country. When his position was terminated at Pac North, they could have offered him another opportunity to work at their hospital.

They have an excellent pediatrics program that many strive to be accepted into, and he would be a perfect fit even years after the fellowship opportunity. It would have been a dream come true and Joe would have pushed him to pursue it, even though it would take him far away from her.

Addiction To Drugs

This one seems unlikely, but perhaps Karev became addicted to drugs after he was laid off from Pac North. It would be easy for a doctor like himself to obtain the substances, and his less-than-perfect background could have led him to this life.

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This wouldn't be one we would personally choose for him as he made such great strides to better himself, although, it was definitely a possibility. We saw so many things go wrong before his departure between Joe's mental illness and the loss of his job that he could have turned to a new outlet to release his feelings.

Karev Could Be Arrested

Alex Arrest Season 13

Karev has always had a temper and has taken it out on several people throughout his time on the show. They could have used this angle to have him sent away for good. This is another unlikely outcome as he seems happy and able to control his own emotions, but something could have triggered his severe anger. It could cause him to beat up the wrong person and end with his license stripped and his presence seemingly out of the show for good.

Became A Vegetable

Weirder things have happened and Karev himself could have become a vegetable or sent into a coma due to some unforeseen traumatic brain injury. This wouldn't kill him, but he also wouldn't be able to do anything as he lies in a bed for months and years until he finally wakes.

We don't know if Joe would have pulled the plug, but it wouldn't be hard to stash a fake body or create some fake scenes where he is lying motionless on a bed. The only issue is that Joe probably would have stuck by his side, but we could also see her moving on after so much time had passed.

Severe Mental Illness

Karev's mother suffered from schizophrenia, so it wouldn't be strange for Karev to develop mental illness later in life. We already know they are pursuing this storyline with Andrew DeLuca, but it would show a quick exit for Karev from the show as he is permanently admitted to a psychiatric ward.

He could have developed a weird brain disease that causes him to enter this quick downward spiral and we could routinely hear reports from Joe on the progression. It wouldn't be ideal, but neither was Karev leaving everything behind to pursue a life with Izzie.

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