<P> Although Karev and Stevens had an on - off romantic history in previous seasons, it was not until the fifth season that the two formed a lasting relationship . Despite Stevens' advanced skin cancer, the two marry . Justin Chambers commented on his character's inability to tell Stevens that he loves her in the beginning of their relationship, saying that Karev has difficulty expressing himself . Though Stevens departs in season 6, series creator Shonda Rhimes has said that she would like the chance to create closure for both Karev and Stevens . Rhimes later retracted her comments and stated that she has no plans to ever re-approach Izzie's storyline again . In the ninth season, Karev befriends intern Jo Wilson . They begin a relationship in the tenth season until their break - up in the twelfth season . </P> <P> His mother had a mental illness, and his father was often absent, as well as often becoming violent towards Alex and his mother . Alex began wrestling in high school, and eventually physically confronted his father - after this, his father did not return . Alex has a younger brother, Aaron, and a younger sister, Amber; they were all placed in foster care for 5 years . Though Aaron and Amber only had a few foster families, Alex went through 17 foster families in 5 years before he reunited with his siblings . It is revealed in later seasons that Aaron was diagnosed with schizophrenia and tried to kill Amber . Alex was present when Aaron had to be committed to a psychiatric ward . </P> <P> Alex secured a position in the surgical residency program at Seattle Grace Hospital after graduating from the University of Iowa . He initially makes a poor impression on his fellow interns meeting fellow interns Meredith Grey (Ellen Pompeo), Cristina Yang (Sandra Oh), George O'Malley (T.R. Knight), and Izzie Stevens (Katherine Heigl) whom he later taunts when he discovers she used to be a lingerie model . After initial disagreements, Alex reveals to Izzie that his father was a heroin addict who used to beat his mother . He became a wrestler so he could defend his mother, and attended university on a wrestling scholarship . He and Izzie begin a friendship . At the end of the first season, George contracts syphilis from Alex through nurse Olivia Harper, causing animosity between the two . </P> <P> Alex asks Izzie out on a date, but he is thrown by the news that he has failed his medical board exams . Izzie is offended since he pays no attention to her during their date and so informs him that she no longer wants to go out with him . He later freezes during an emergency operation, needing George to take over from him . Alex's relationship with Izzie is damaged when he experiences erectile dysfunction with her . He goes on to sleep with Olivia again, and is caught by Izzie and they break up . After retaking his exams, Alex manages a pass, and reunites with Izzie after a bomb scare in the hospital . They break up again, however, when Izzie falls for cardiothoracic patient Denny Duquette . </P>

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