Grey Sloan Memorial Hospital has lost doctors before, but perhaps no loss has been as sudden or as confusing as the departure of series original Justin Chambers, who suddenly vanished from the medical drama after the milestone 350th episode. But where is Grey's Anatomy's Alex Karev? Viewers are left to answer that question for themselves, since the show hasn't offered up an explanation as to the fan-favorite's whereabouts, even after Chambers confirmed his departure on Jan. 10, and that his final episode had already aired on Nov. 14.
Given that the show has a penchant for knocking off departing cast members in deadly style, some fans theorized that Dr. Karev would be killed during the dramatic events of the winter premiere, a crossover with spinoff Station 19 that saw several characters from both shows put in peril when a car crashed into Joe's Pub. Would Alex prove to have been the person behind the wheel of that vehicle? Could he have been hit by the car outside the pub before it came flying through the window? However, when Grey's returned from its midseason hiatus on Jan. 23 and resolved that cliffhanger, Alex was nowhere to be seen — dead or alive — and his status and whereabouts still remain unresolved.
In the absence of answers, here are some of the most prominent theories about Alex's disappearance:
1. He Will Stay In Iowa
The last time Alex was seen, in the pivotal episode "My Shot," he was defending Meredith at her hearing; in the subsequent episode, the winter finale, it was mentioned that he had returned to Iowa to visit his mother. In this, the Occam's Razor of theories, the simplest answer is that Alex will simply stay there to care for his mother. Over time, the formerly selfish character has evolved into quite the caretaker, tending to Ava/Rebecca after her ferry boat accident, to Izzie when she had cancer, and to Meredith after her brutal attack. He would undoubtedly do the same for his mother if she showed signs of struggling with her mental illness again.
What this would mean for Alex's marriage to Jo is an open question, however. Will they stay together long-distance? Will they break up? Will she leave the show to join him in Iowa?
2. He Will Die Off-Screen
Alternately, given that bringing Alex back from Iowa isn't an option, the writers may simply kill him offscreen. It's been five seasons since the show's last big death, when Derek died in Season 11, and it would be fairly easy for them to mention that he had been in a plane crash or a car accident on his way back to Seattle from visiting his mother. This would allow the show to keep Jo without having to explain her separation from Alex, and provide juicy dramatic material for her and Meredith to go through.
3. He Will Return To Africa
During Meredith's hearing, the show may have provided itself with a perfect excuse to write Alex off while cycling back through some of Meredith's medical history. Among her many exploits that were revisited during the episode, viewers were reminded about her adoption of Zola, which originated through Alex's Africa Project. (During the battle to become chief resident in Season 7, Alex threw his hat in the ring by getting a bunch of kids in need of surgery flown in from Africa.) Now that the writers have reminded viewers of this past project, perhaps they can use it as an excuse to ship Alex off somewhere he won't be seen, by resurrecting this project and sending him over to Africa full-time, as Reddit user YoItsMCat theorizes.
4. He Will Leave Jo
Unless Jo leaves as well, it seems likely that Alex's departure means no happy ending for the newly-married couple. In fact, some viewers are afraid that the show will explain Alex's absence by doing something drastic to break them up — like having Jo cheat on Alex, as Reddit user DarthRen87 posits. According to this theory, a despondent Link, grieving after finding out that Amelia's baby isn't his, goes to his friend Jo for comfort… and the two end up sleeping together. After Jo confesses her infidelity to Alex over the phone, he's so heartbroken he chooses never to return to Seattle.
5. He Will Headline A Pac-North Spinoff
This one's probably a pipe dream, but Reddit user synthbop is hopeful that the real reason Chambers is leaving Grey's Anatomy is because he's about to headline his own Pac-North-centric spinoff — à la Ben leaving to headline Station 19 or Addison leaving for Private Practice. As cool as this would be for Chambers, such a turn of events is probably not in the cards; it almost certainly would have been announced in tandem with news of his departure, and it would also require Pac-North employees Richard and Owen to leave Grey's as well, and there's been no word about them going anywhere.
6. He Will Get Plastic Surgery
In what would be the most soap opera-esque twist possible, Spoilerist theorizes that while Chambers will be leaving the show, Alex won't… because he's going to have an accident that leaves his face disfigured. After plastic surgery reconstruction, he looks totally different — allowing Alex to stay on the show, although played by a different actor. While this certainly would be a twist worthy of old school Grey's, fans would almost certainly riot if the writers simply chose to recast the role of Alex Karev.
7. He Will Simply Never Be Seen Again
Most distressingly, there's the possibility that Alex is simply never seen again, his status is rarely mentioned, and his character is never given a big sendoff or explanation. Now that Meredith is back at Grey Sloan, the show can focus more on that hospital again and less on Pac-North; maybe he does come back from Iowa, maybe he and Jo do stay together, and she simply mentions every now and then that he's working and happy over at the other hospital, and the memory of Alex slowly fades into the background. Not quite the emotional farewell that characters like Cristina and Callie received, but at least they wouldn't have to kill him off for shock value, and there would always be the possibility that Chambers could return for the series finale or other milestone moments on the show.
Whatever the reason for Alex's absence, the show will surely have to address it sooner rather than later. With Season 16 still filming, there's plenty of time to insert an explanation to help viewers cope with this distressing turn of events. No explanation will be satisfying, but it would be nice to at least get some form of closure. After 16 years of being invested in Alex Karev, the show owes fans that much at least.