Shortly after surviving cancer, Izzie left to find herself - who she really was. She left her whole entire life behind. She left Alex who was so crazy in love with her and stuck by her no matter what obstacles they got.
After a few years of disappearance she came back to Seattle, and went to find for Alex but then she found out that he was already in a relationship with someone else who's name is Jo Wilson.
She then didn't confess anything to Alex because she didn't want to be a home wrecker and saw how happy he was with her but instead she decided to stay and try to get back her old job and decided that she wanted her specialty to he OB/GYN as she found it therapeutic for her.
She has always wanted cardiothoracic surgery but then Cristina wanted to specialise in it and she realised that there was no point in trying to compete for it with Cristina as Cristina has always been determined on what she wanted and Izzie simply wanted it because it reminded her of denny her first ever love that died due to heart complications and her cutting the LVAD
Though Denny will always be one of the few people she loved the most it doesn't change the fact that Alex was her soulmate and he knew her best. Izzie will always have a special place in her heart for Denny but Alex matters most because he's alive.
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In another dimension
FantasyIn another life where all the Grey's characters stays alive and didn't leave or die and everyone got their happy ending... Or did they?