Patient Privilege by Allison Cassatta

Dreamspinner presents

patient priv.Blurb

Dr Erik Daniels hasn’t had it easy. After losing love and fighting addiction, he becomes a successful substance abuse counselor and helps people regardless of their insurance or ability to pay. It isn’t the dream life he had in San Francisco, but at least he has something to be proud of. Everything seems to be getting back on the right track until Angel, a heroin-addicted male prostitute, crosses his path. Erik not only sees a lot of himself in Angel, but a lot of potential as well. He quickly realizes he’s willing to sacrifice a lot to get him on the right path–but is he willing to jeopardize his career?


Erik Daniels is a rehab counselor who got into the profession after succumbing to his own alcohol addiction, which ruined his career and his relationship with Marshall, several years ago. Now, he’s working in a run-down rehab clinic but feels great about his life. He meets Angel and Jon in the hospital after almost losing a different patient and can’t get the young couple out of his mind.

Angel is a heroin addict and a rent boy who is loved by Jon. Jon pushes and pushes to get Angel into rehab but Angel doesn’t think he’s worth it or that the clean life is worth it. Finally, with Erik’s help, Angel agrees.

Things are complex though. Angel doesn’t love Jon. Jon loves Angel. Angel pushes Jon away and so Jon finds a new “love”. Angel is crushed so Angel turns to Erik for love.

And… Erik loved Marshall but Marshall pushed Erik away when Erik hit rock bottom and went into rehab. Now, suddenly, several years later, Marshall returns wanting Erik back, and Erik sort of wants Marshall back, but fears Marshall’s not good for Erik’s recovery. Marshall pushes for a relationship, so Erik and Marshall start a long-distance fling, then Marshall pushes Erik to move back to San Francisco, but Erik resists. Meanwhile, Erik falls for Angel but knows it’s unprofessional and maybe wrong, but Erik can’t resist. Until, finally, Angel and Erik end up together.

Phew, that’s a lot of drama!

There were parts of this book I really loved: the writing, the theme, the MCs, and even the secondary characters. I thought Allison Cassatta did a great job creating believable characters and a rich environment for them to interact in. She’s got a lovely writing style that flows well and is easy to follow and it was easy to become immersed in her story.

But… there was a lot I didn’t like: First, I didn’t feel comfortable with Erik and Angel’s love story. It felt too co-dependent and very unhealthy for Angel (who never even reclaimed his real name for Pete’s sake. Erik is still calling him Angel (not Luke, his given name) at the end of the book, without an explanation as to why. If he’d said something like, “I feel more like Angel than Luke so I’m keeping it” I’d have understood, but it’s just kind of left there, unexplained.

Second, Angel is too young (emotionally – not in years) for Erik and Erik is not in a good place to become his lover. I was willing to let the Doctor/Patient thing go IF, and that’s a big IF, it was explained and justified. I don’t feel it was. The end, where the two get together, is just too rushed for that to be overlooked as a real, significant, hurdle.

Third, I never liked Angel’s reasons for any of his actions. I didn’t get why he chose to live on the streets, I didn’t get where he fell in love with Erik, I didn’t get why he was so devastated when Jon did what he was told and found someone else. Sure, I get that he was a proud young guy who was rejected at home, but it seems he gave up trying to find his way with little effort and didn’t ever come back to a healthy place where I felt he had a chance at long term sobriety.

Fourth, I really didn’t like that most of the on page sex and relationship stuff was between the MCs and their secondary characters (Jon and Marshall) and not with each other. Those relationships really felt unsettled, especially between Marshall and Erik. I definitely agree that Marshall and Jon were not the right men for Angel and Erik but I didn’t feel we got enough time with Erik and Angel as a couple to feel good about their relationship. Erik and Angel were left feeling very co-dependent on each other and it didn’t feel healthy, even at the end.

I think if the story’d been a bit longer I’d have felt better about things. Maybe it was because the story ends with Erik and Angel hooking up and then the epilogue, a year later, tells us of the couple’s successes. If I’d read more about that time I’d have a better connection to that success. The ending just felt rushed.

So – overall I have to give this story a 3 of 5 hearts instead of the 4 or 4.5 that I was leaning towards in the beginning because I just didn’t feel good about the ending – even though I loved that they seemed so happy together at the end.