The novel weaves together a few different plot threads:
* The relationship between Vasiht'h and Jahir, as roommates, friends and partners
* Their tele/empathic powers and the way they interact with one another
* Their education in psychiatry and their choice of specialization/career path
* Their relationships with other students and faculty on the campus
* Their friendship with a group of six critically ill children who are patient-in-residence at a nearby hospital
I list these in approximately the order of how much I enjoyed them. The friendship and anxieties about same between the protagonists is sweet and endearing. The protagonists are well-drawn and delightful. They are distinct, each with his own strengths and weaknesses. The choice to make each a viewpoint character works well, letting the reader see both what they're like on the inside and how that differs from the way others see them.
The approach to telepathy/empathy is interesting. It's very synesthetic in description, often portrayed as flavors or scents. For both characters, it's increased by touch, particularly skin-to-skin. But otherwise, the characters have drastically different approaches. For Vasiht'h, it's a thing he can do, that he rarely uses, and that's about it. For Jahir, it's a disability that he struggles to mitigate. I read a lot of books with psychic characters in my formative years, and I'm pretty burned out on them, particularly on the psychic-powers-as-curse trope. Still, Jahir's case was interesting, because it really does feel like a crippling disability, and not even for the "society doesn't understand me" reason. Nope; it's "I can pass out from the stress of having people touch me unexpectedly". One doesn't hear much about Jahir's background, despite him being a POV character. He's a member of the mysterious, secretive, xenophobic Eldritch race. At one point during the book, one of the other characters says that Jahir's extremely reserved, controlled manner is similar to one might expect from a psychopath, military operative, or abuse victim. That last option is never mentioned again, but it resonated with me because the hints about his society sound rather dysfunctional. Not abusive in an obvious or malicious way, just ... dysfunctional.
There's a lot about the university, their studies, classes, and choices. I found this less engaging overall, but still interesting.
Then there are assorted minor characters, most of whom blended together for me. Mostly they felt like foils for the protagonists to demonstrate their skills upon or to bounce ideas off of. The six critically-ill kids especially felt interchangeable. This may be an inevitable result of having a very large cast in a single standard-length novel, but it did mean I got bored reading conversations with characters I didn't feel any attachment to. The kids compounded this by being too sweet and adorable. I wanted one of them to throw a tantrum and scream, or at least be sulky and obstinate, at least once. The scenes with them had some d'aww and good lines, but felt particularly unconvincing.
The theme of "grief and the inevitability of death" is partly brought out by the six critically ill kids, but the main reason it's an issue is that Jahir's race has a natural lifespan around 1500 years, which is 10-12 times that of all the other characters. He's 150 years old but everyone thinks of him as a "young man"; he never really acts like he's significantly older than his fellow students. Having chosen to leave his own people (at least for a while) to live with the short-lived Alliance races, Jahir is troubled by the prospect of watching generation after generation of them grow old and die. Since this is a high-tech society that's been spacefaring for centuries without major increases in lifespan, it doesn't seem likely that this problem is going to go away. Jahir thinks about it a lot. Honestly, not sure it's any less depressing to think "everyone I know will be dead in a hundred years" when that includes you than when it doesn't. (In other news, I am past due for my mid-life crisis.)
The first part of the book was slow for my tastes; it became more engaging around the second half. It's very definitely Part One of a Series: the ending leaves the central issue of the novel (ie, the asexual romance between the two protagonists) unresolved.
Overall, I liked the book and plan to read the sequel, though not right away. I'll rate it a 7.