Arizona is Alex's mentor and the two have maintained a close relationship because of that. The investigator finds him and tells Alex that he will be at a conference. Stark denied him, however, because despite all of Alex's good intentions, he wasn't good at organizing the logistic part of the project, coming off as disorganized and "half-assed", according to Stark. He also sent her divorce papers.
The meeting was very productive for the couple. However on that very day, he found out from the Chief that he failed his medical board exams. After returning to work, Alex and Jo try to ignore each other and eventually build up a tolerance of sorts towards each other. He apologized to her and continued by telling her "[she] came back" and tearfully begging her never to leave him again; Lexie, declining to correct him, assured him that she never would. After learning that Jo was married, which she was worried about being discovered during the trial, Alex decided to take the plea deal, which involved him serving two years.Alex went to the District Attorney's office to take the plea deal, but Andrew unexpectedly walked in and tried to drop all charges against Alex. However, their sex life hit a bump when Alex had difficulties performing. He wanted Addison to release him from her service, and she did. Webber recommended Bailey to fill Yang's board seat after she left, so Bailey and Alex fight over the chair. The bartender treated Alex to a beer on the house. She told him at wasn't about the kids. The project was temporarily threatened when a new doctor, When Meredith was working on Derek's Alzheimer's trial, Alex spotted her walking down the hall with a trial packet under her lab coat. She knew how to rise when she had to, but she needed help.
April had registered for them so they ended up with a bunch of stuff they didn't need. During surgery, Richard talked about missing working at Grey Sloan as he had imagined himself dropping dead one day in OR 2, which made him happy. Though Aaron and Amber only had a few foster families, Alex went through 17 foster families in 5 years before he reunited with his s Once she got there, she stopped answering his calls, worrying him. Over time, he started dating other girls and his love for Izzie faded. Alex said that he was staying with Izzie and their two children (Alexis and Eli) in Kansas and wouldn't be coming back to Seattle, because he wanted to ensure his kids didn't grow up like he did, without a father, along with the fact that he loved Izzie.Despite the callous image he projects, Alex is particularly affected when he treats addicts and abused children because of his childhood background. In the sixteenth season, Alex leaves Seattle to be with Izzie and their children. But, when the two rush to the police they find Alex being arrested for aggravated assault, as he had turned himself in. Furious, she informs a stunned Alex that he would be placed permanently under her service. Alex took the investors to his office and explained the situation properly.
Alex and Jo continue to struggle with their relationship. Alex left the group in Richard's hands and went with the worker, who showed him they had come across skeletal remains while digging. Alex has a younger brother, Aaron, and a younger sister, Amber; they were all placed in foster care for 5 years. Alex then had Bailey cover him. Offended when Alex referred to the still-living Denny as a "corpse", she dumped him saying, "Just so we’re clear, we’re over. Alex and Owen traced the source of the problem back to a broken fridge in the ICU's blood supply. In the beginning, Izzie disliked him as he was arrogant and cocky. The two avoided each other almost entirely after their fight. Meredith told him he wasn't alone yet and took over. His final physical appearance is in the episode Jo and Alex fight over his father, but Alex realizes Jo was doing it because she loved him. On your very best day, that 'corpse' is twice the man you will ever be.
He once again told her she could tell him anything as he wouldn't judge given his own family history. Alex was pulled onto an emergent case with Richard of a man who nearly died in the ER's waiting room. She couldn't take care of herself and so he did everything for her, insisting that she was fine. She accosted Alex and the two proceeded to have sex in a linen closet.
Alex sent Levi to go pick up the donor, who was severely agoraphobic, at the airport.