I read this through in one day and couldn't put it down. I really liked the whole set up--James' sci-fi background, Michael's mix of empathetic and insecure, the dynamic between them. To my surprise, I especially liked the flashbacks and the excerpts of James' story, interruptions which usually make me impatient and howling to get back to the main story.
I can't say in the end, though, that I was completely satisfied, like this might become a favorite book. The character of Marnie rang some early warning bells of where my problems lay. I am very leery of characters like that anyway, mostly because they seem designed to play on the heartstrings or otherwise reveal the virtues of the main character, rather than acting like independently motivated human beings. And frankly, it wasn't just Marnie. Michael's other patients also seemed to exist to show how saintly and compassionate he is--of course he should help these poor lost souls. But it was a bit too much for me, as if they'd been carefully conceived to serve as "proof" that sexual surrogacy is a legitimate, necessary therapeutic approach to real problems--rather like bringing out Tiny Tim to justify the welfare state. I felt like the deck was being stacked, arguments marshaled against those who denounce the therapy as prostitution or phony or whatever. It's risky to base an argument on two such completely deserving examples, and it had the unintended effect of raising my skepticism more than it might otherwise have been if the patients had been more balanced, flawed characters. I'd never heard of sexual surrogacy before this series and from what the book shows, it sounds like it could really help people, but I'd need less obviously sentimental examples to make me understand it.
Bottom line: Easton is obviously a terrific writer and I totally understand why this book was so popular. I loved the life of a sci-fi writer and the account of James' experience in India. But overall, I found the treatment of Michael's sexual surrogacy to be too sentimental to be persuasive.
Added: an extra little niggle: I haven't read the second volume so I apologize if the character is given a fuller treatment there, but I had a problem with the depiction of the Miss Lonelyhearts receptionist at the clinic. The treatment of her veered perilously close to Disney's of Cinderella's ugly step sisters, that is to say, her pursuit of clearly gay men is treated as pathetic and/or ridiculous. It felt especially egregious given the sex clinic setting. Why aren't her inappropriate desires treated with the same respect and therapeutic compassion as Tony's "picky dick" or Lem's fear of touch? I feel a little sheepish making a big deal about it, since it really is a small point about a very minor character, but it hit a personal nerve. As a culture we are way too quick to show contempt towards women who lust after men who are unavailable to them--e.g. "fag hags." I really hope the character gets a fuller, more humane treatment in a later book.