Viewers had a major reason to be concerned about Alex Karev.
So did all of his friends at Grey Sloan Memorial. Oh, and we can’t forget about his wife, who has seemed like a mere afterthought ever since he decided to skip town.
Indeed, Justin Chambers has left Grey’s Anatomy, and while Thursday’s episode was mostly a clip show that showed Alex’s best moments with the characters he touched the most, it gave This Is Us a run for its money in terms of drama.

Alex sent letters to Meredith, Jo, and Bailey, aka the three most important women in his life for a very long time.
All of these letters were sent from Kansas, which is a couple of thousand miles away from where he was supposed to be.
Grey’s has a habit of killing series regulars off, and the letters certainly made it seem like he could have killed himself and wanted to thanks those who made an impact on his life.
Instead, he was in Kansas, being a father to his two children. Turns out, Izzie used the frozen embryos she created with Alex and gave birth to their twins.
Izzie never came clean to Alex until he called her to write a letter to support Meredith.
Then again, Alex gave away the rights to those embryos when Izzie skipped town of her own accord around a decade ago.
The show first teased viewers with Meredith’s letter, before Alex narrated them so that the fans didn’t have to read.
“I left and I’m with Izzie,” Alex writes in the letter as Meredith let out an audible gasp.
Meredith has to feel somewhat responsible because he would have no clue about the children if he didn’t contact Izzie on her behalf.
Alex admitted to his BFF that he reached out to Izzie and was just looking for the time to call her to get an update on how she "landed."
Alex was shocked to learn that the twins had been born, but more so that she was living on a farm in Baldwin City, Kansas, and was a successful oncologist.
Izzie named the twins Eli and Alexis, and we got to see small clips of the twins and their life on the farm.
Alex also revealed that if it was just Izzie and Jo, Izzie would win hands down, but the kids being involved changed everything about the situation.
If you watch Grey’s Anatomy online, you know Alex raised himself and was apprehensive about having kids as a result.
He worried that they would suffer with terrible parents like he did, and that’s why he rushed to care for them the moment Izzie opened up about it.
In his letter to Jo, he says this is “officially the worst thing I’ve ever done.” We agree, but Alex followed his heart, and that’s commendable.
It’s just a shame he stuck the knife in further with Jo by telling her he had already signed the divorce papers. To sweeten the deal, he left Jo everything, including his shares in the hospital.
Jo recently concluded that her husband had left her, but she was determined not to dwell on what happened. As such, she returns to work after learning the truth.
Given that Chambers exited the series, this is the best goodbye they could have given him.
What did you think of it all?
Hit the comments below.
Grey’s Anatomy airs Thursdays on ABC.