Alex Karev isn't coming back.

Left his wife,

his friends, his job.

Alex Karev is now a father of two with Izzie Stevens.

And, if they take my recommendation seriously,

he'll soon be Chief of Peds at Shawnee Memorial.

What's this got to do with Joey?

[ Chuckles ]

Now, it is a matter of luck,

of grace that Alex Karev is who he is today.

He could have just as easily been lost to this world,

aimless.

But he survived his home,

his family, his foster homes

and became a man,

now a father,

a fine surgeon by luck,

by chance.

[ Sighs ]

Joey's future shouldn't be a matter of chance.

A child's future can't be a matter of luck.

Okay.

"Okay"?

Just like that? "Okay"?

I just wanted to talk about it.

I mean, you and I, look, we -- we both make

these big, sweeping decisions without each other.

You -- You had a heart attack and didn't tell me.

You -- You had a miscarriage and shut me out.

You -- You change careers like sweaters.

[ Chuckles ] Yeah.

And I am down for all of it. I...

All the change and the easy and the hard that comes with it.

Of course Joey should have you.

Should have us.

He should have a family.

But...

that family needs to learn to talk to each other first, okay?

I'm sorry.

I know.

I'm sorry. I'm sorry.

Congratulations, Miranda.

It's a boy.

A teenage boy!

[ Chuckles ]

It's another boy.

[ Plested's "Beautiful & Brutal" plays ]

♪

♪ I don't know what, I don't know what ♪

♪ I don't know what's happening ♪

You can quit hovering. I'm not hovering.

♪ I swallow the pain, drink in your poison ♪ I'm...deciding

whether to come in or give you space... ♪ Darling, it hurts so sweet ♪

♪ I try to run, try to run ♪ ...or take you day drinking.

♪ But I come back again ♪

Okay, whiskey it is.

♪ I look in your eyes, don't have a choice, yeah ♪ [ Sighs ]

[ Pager beeps ]

[ Sighs ] ♪ You'll be the death of me ♪

Pierce is paging me for a cecal bascule

for one of our cabbage patients.

♪

Okay. ♪ It'll cut you deep ♪

Whiskey tonight. ♪ It'll watch you bleed ♪

Today I am working.

♪ Nothing hits as hard as when we touch ♪

♪ How beautiful and brutal is your love? ♪ Link: You're my hero.

Mine, too.

We hold onto hope,

thinking one small detail,

one tiny piece of information

will somehow make things right,

make it different,

make it okay...

stop the world from spinning off its axis.

Mom, Uncle Alex said when I finish my science project,

I'm supposed to show him.

Can you show me?

He helped me come up with it.

It's a dog feeder. See?

When the dog walks on this lever,

the pulley tips the bucket over and...

[ Dog food pours ] That is so smart!

[ Laughs ] All we need is a dog.

[ Both laugh ]

So, can I show him?

Can we go and show Uncle Alex right now, please?

♪ Don't care how hard I gotta suffer ♪ Um...

[ Pats sofa ] Come sit here.

♪ I'm waking up in your covers ♪

♪ Beautiful and brutal ♪ Your Uncle Alex loves you so much.

♪ Cuts you deep ♪ [ Laughs ]

And I just got a letter from him.

♪ It'll watch you bleed ♪ You did? I did.

When the truth is...

♪ Nothing hits as hard as when we touch ♪ 00:04:41.490,00:00:00.000 ...there's really no good way to say goodbye.