Past stars returning to Grey’s Anatomy foster continuity

between the long-running show’s past and present.
Both Izzie Stevens and Alex Karev had abrupt, unsatisfying exists from the show.
The return of pediatric surgeon Arizona Robbins sets the stage

for Alex and Izzie’s potential return, especially since the pair have young twins.
Ahead of its landmark 20th season, Grey’s Anatomy has already revealed

that past stars will appear in new episodes. From Ellen Pompeo’s Meredith Grey,

who hasn’t quite left the long-running show for good, to Jessica

Capshaw’s Arizona Robbins, the returning leads of the medical drama’s

past seasons offer some continuity between the “then” and “now.” That said, one Grey’s Anatomy fan theory reveals the most logical way for Grey Sloan vets Izzie Stevens (Katherine Heigl) and Alex Karev (Justin Chambers) to return in season 20 and amend their characters’ divisive exits.

Viewers now know why Katherine Heigl left Grey’s Anatomy after 5 years: the actor and series creator Shonda Rhimes didn’t get along, prompting Heigl to request an early release from her contract. While Izzie was gradually written out of the show, leaving her then-husband Karev to deal with the emotional fallout, Chambers’ character left rather abruptly after 15 years on the medical drama. Alex Karev’s controversial Grey’s Anatomy exit saw him abandoning his new partner, Jo Wilson (Camilla Luddington), to forge a life with Izzie — something he explained in letters he left for Jo, Meredith, and others.

Winston Ndugu (Anthony Hill) and Teddy Altman (Kim Raver) from Grey’s Anatomy season 19
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How Grey’s Anatomy Season 20 Can Bring Izzie Stevens & Alex Karev Back
Alex Karev’s children on a farm with Izzie Stevens in Grey’s Anatomy.
In the past, Grey’s Anatomy killed off main characters in order to write actors off of the series. The pattern generated some backlash from fans, especially since various character deaths closed the door on fan-favorite personalities returning to Grey Sloan in guest roles. Attempting to learn from the show’s past, the Grey’s writers didn’t kill off Alex Karev when Chambers decided to leave the series to pursue other acting avenues. However, Karev’s sudden, out-of-character departure provided little closure. In letters, it was revealed that Karev left after getting back in touch with Izzie, his first wife.

Once Alex learns that he has children with Izzie, he can’t imagine staying in Seattle.

In season 12, Jo wonders if her then-husband, Alex, has children with Izzie after finding an invoice from a fertility clinic. Back when Izzie was diagnosed with cancer, the pair stored their fertilized embryos for potential use in the future. Evidently, Izzie did go head with IVF. A surgical oncologist living in rural Kansas, Izzie has five-year-old twins, Alexis and Eli. Once Alex learns that he has children with Izzie, he can’t imagine staying in Seattle. Since the kids were the reason Alex left Jo and Grey Sloan, it makes sense that he’d only return to the hospital if his and Izzie’s children needed top-notch medical treatment.

Arizona’s Return Means Peds Will Be A Focus Of Grey’s Anatomy Season 20
Given the incredibly messy way Alex left the show, very few things would push him to return to Seattle and come face-to-face with Jo again. Clearly, Alex’s children mean the world to him; Karev upended his life (and Jo’s) in order to be a present father. If the twins come down with a serious illness or condition, it makes sense that Karev (and Izzie) would seek out the best treatment. While Grey Sloan’s pediatric surgery department has had a revolving door of surgeons, Karev’s former mentor, Arizona Robbins, is set to return in Grey’s Anatomy season 20.

Alex Karev wasn’t originally written into the Grey’s Anatomy pilot script.

A leading pediatric surgeon, Arizona Robbins exited Grey’s Anatomy in season 14 in order to live closer to her daughter, Sofia, and her co-parent, Callie Torres (Sara Ramirez). Capshaw’s surprise return to Grey Sloan suggests that the hospital’s pediatric surgery department will play a crucial role in the upcoming season. Plus, Karev bringing his own children in to see Robbins would be a poignant, full-circle sort of moment. While Izzie might not have the same insight into her former employer’s pediatric surgery record, she’d no doubt trust Alex to make the right call.

Natalie Morales’ New Grey’s Anatomy Character Is Also A Pediatric Surgeon
Jessica Chapshaw’s character isn’t the only element of the show that’s putting a renewed focus on peds. In addition to Arizona’s season 20 Grey’s Anatomy return, the show cast Natalie Morales (Dead to Me) as a no-nonsense pediatric surgeon. Morales’ doctor’s reported matter-of-fact personality is a perfect contrast to Arizona’s more bubbly, optimistic point of view. The appearance of two world-class pediatric surgeons hints at a renewed focus on peds storylines. While other series regulars’ kids could be the focus of such narratives, it seems like a great opening for Izzie and Alex’s return.

Not to mention, Alex Karev is Grey Sloan’s former Head of Pediatric Surgery. When he and his cohort were picking specialties, Karev discovered his knack for working with children — and for advocating for patients who couldn’t make their own choices. Despite his playboy facade, Alex proved to be one of Grey’s Anatomy’s most thoughtful, caring characters. A storyline that sees Karev, Izzie, and their twins returning as patients to Grey Sloan — the place Alex discovered his passion for peds and saved so many young lives — feels incredibly fitting.

Katherine Heigl’s Izzie Stevens left Grey’s Anatomy in season 6.

Katherine Heigl & Justin Chambers Both Deserve Better Grey’s Anatomy Endings
Katherine Hiegl as Izzie Stevens crying on Grey’s Anatomy
While there isn’t necessarily a pressing reason to bring Izzie Stevens and Alex Karev back to Grey Sloan Memorial Hospital, the guest appearances of both characters would be a welcome bit of fan service. Both Heigl and Chambers had awkward, unsatisfying exits from Grey’s Anatomy. Seeing as how they were key parts of Meredith Grey’s intern class, it’s a disservice to the show as a whole to leave Izzie and Karev’s on-screen arcs so unfinished. In recent years, Hiegl has warmed to the idea of returning to the show, and Chambers hasn’t completely stepped away from the fandom either.

Teddy Altman (Kim Raver) looks concerned and Owen Hunt (Kevin McKidd) looks serious in Grey’s Anatomy
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To make matters even more promising, Heigl and Chambers joined Pompeo and long-time series stars Chandra Wilson, who plays Dr. Miranda Bailey, and James Pickens Jr., who plays Dr. Richard Webber, on stage at the 2024 Primetime Emmy Awards. The five actors represented Grey’s Anatomy and its landmark achievements, perhaps hinting at Heigl and Chambers’ return to the series. Regardless of whether the Emmys’ moment meant something more, there’s no denying that both Izzie Stevens and Alex Karev deserve better Grey’s Anatomy send-offs — and season 20 can deliver.