<P> Alexander "Alex" Michael Karev, M.D. is a fictional character on the ABC television series Grey's Anatomy, portrayed by actor Justin Chambers . Introduced as a surgical intern at the fictional Seattle Grace Hospital, Karev eventually obtained the position of resident, later becoming a pediatric surgical fellow . His relationships with colleagues Meredith Grey (Ellen Pompeo), Cristina Yang (Sandra Oh), Izzie Stevens (Katherine Heigl), and George O'Malley (T.R. Knight) formed a focal point of the series . </P> <P> The character is initially disliked by his fellow interns, and is often accused of being brusque and dismissive with his patients and co-workers . As a resident, Karev's negative attitude, temper and rudeness has occasionally earned the ire of the attendings, with former neonatal surgeon Addison Montgomery requesting him on her service as punishment for his rudeness to her and neurosurgeon Derek Shepherd, amongst others, throwing him out of their service for his inappropriate comments about patients . He demonstrates profound skill for the specialty which prompts praise from Montgomery and contributes to Karev's interest in pediatric surgery for the rest of the series . As the character developed, he displayed more empathy for patients and is shown to have a gift for connecting with young children, despite his repeated claims to dislike them . </P> <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 . However, they get back together again in the fourteenth 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>

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