One of Grey’s Anatomy’s best storylines centered on how Dr. Alex Karev unexpectedly succeeded in his role as interim chief of surgery. In Grey’s Anatomy season 15, Dr. Bailey was feeling the stress of her job and decided to temporarily give up her position as chief, so she could conduct research with Jo Wilson. Many characters on the show approached Bailey for the position to pitch why they’d be a good fit for it. Surprisingly, Bailey’s chose Karev, shocking her colleagues and the show’s audience — though the decision wasn’t entirely unwelcome.
An easy choice for Bailey would’ve been either Dr. Richard Webber or Grey’s Anatomy‘s Dr. Owen Hunt, who had both previously served as chief of surgery. However, after a conversation with Dr. Atticus “Link” Lincoln, Bailey realized she didn’t want to temporarily hand over the position to someone who could do it better than her; hence why she chose Karev. It came as a surprise to both Bailey and audiences when Karev exceeded expectations. As interim chief of surgery, Karev was fair and treated the interns well — something that came as a shock to a lot of people, considering his dislike of Dr. Levi Schmidt.
By excelling as the interim chief of surgery, Alex Karev’s character arc came full circle. In Grey’s Anatomy season 1, Karev was extremely unlikeable, with the show essentially framing him as a bad guy. Many of these attributes lessened over time as the character further developed, and by the time Alex met Jo Wilson in Grey’s Anatomy season 9, he was a changed man for the better. Karev stopped looking out for only himself, as he began vouching for the people he cared about.
After Cristina left, Meredith adopted Karev as her person, which Karev took very seriously. Through this bond with Meredith, combined with his time as interim chief, Karev began to have more confidence in himself. When he and Richard were fired from Grey Sloan, Alex took on the role of chief of surgery at Pacific-Northwest (Pac-North) hospital, despite all of the hospital’s issues. This partly showed how well he had grown as a leader. Karev was no longer just a good surgeon, but also a capable hospital leader.
Despite what Miranda Bailey and Richard Webber thought, Karev served as an exceptional chief at Grey Sloan. Even though Karev started on the wrong foot, practically blowing the budget on the first day, he recovered smoothly. Karev learned to delegate tasks easily, whether it be to interns or other department heads. Richard pegging Karev to be the chief at Pac-North shows how highly Richard thought of Alex’s time as chief—even if Richard and Bailey promised to never admit this to Karev.
It was a shame that one of Alex Karev’s last storylines was arguably one of his best. While it’s satisfying for audiences to know that Alex’s character arc went full circle, the way Alex Karev exited Grey’s Anatomy still goes down as one of the show’s worst character exits. However, Grey’s Anatomy fans should be happy that Shonda Rhimes kept expanding the character of Alex Karev and let him truly have some of the most meaningful character developments of any Grey’s Anatomy character.
More: Grey’s Anatomy: Every Main Character Who Was Killed Off (& Why)