Set in San Francisco, “The Fitful Sleep of Immigrants” by Orlando Ortega-Medina is striking because the author manages to pack so many elements into a novel that is part thriller, part psychological study.

The narrator, Marc Mendes, is an attorney in his early 30s in a small San Francisco law firm that specializes in workplace discrimination and harassment cases. He lives in a high-rise apartment building with his longtime lover, Isaac Perez, and Isaac’s mother, Miriam, both of whom are immigrants from El Salvador.

Marc is feeling strained. Sorely overworked, he feels his sense of purpose conflicts with the direction that senior partner Ed Haddad is taking their firm. Marc is also estranged from his Cuba-born parents, Jews with Syrian roots who now live in Los Angeles. And despite long being clean, he is ever conscious that the stresses in his life increase the risk of relapsing into the drug addiction that plagued his earlier adult years.

His ability to hold his life together frays when several unfortunate events coincide to bring him to the edge. Ed dumps a case on Marc that sparks accusations of treachery from members of the gay community. Isaac’s beloved mother — and his only family member who survived El Salvador’s civil war — dies unexpectedly. And Isaac receives a letter from the government threatening him with deportation.

Against this backdrop is the persistent presence of Alejandro Silva, an ethically slippery client who becomes especially insistent about becoming Marc’s lover after their professional relationship ends. Offering feeble resistance to Alejandro, Marc permits himself to be drawn into a pattern of lies and risky behavior that threatens his relationship with the anchor of his life, Isaac.

The novel at times has elements of a thriller, with Alejandro’s stalking behavior recalling the dynamics of “Fatal Attraction.” It is also part courtroom procedural, with the preparation of Isaac’s asylum case and his immigration hearing recounted in some detail. But what I found most compelling in the novel is its psychological portrait of someone whose inability to address his inner issues threatens to upend the stable romantic relationship and professional career he has built.

One of these issues is Marc’s relationship, or lack thereof, with his parents — and particularly with his father, an Orthodox rabbi who previously hoped Marc would follow him into the rabbinate. Marc’s former drug addiction is a source of shame, as is his sexual orientation. He’s never had the nerve to come out as gay to his parents.

Staying away from them allows Marc to evade honest communication. At one point, he resigns himself to accepting their invitation to a seder after an eight-year absence. He decides to bring Isaac and tells him, “I can’t even imagine what it’s going to feel like sitting around the dinner table, everyone staring at me, judging me.” What he doesn’t grasp is what he eventually experiences — that his parents care about him deeply and that his traditionalist father is much more upset about Marc’s cutting them out of his life than about his homosexuality.

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There is another element fueling Marc’s self-sabotaging behavior. He is haunted by the circumstances in which his first boyfriend, whom he spent time with both in L.A. and Israel, died tragically. Frequent flashbacks to their time in Israel indicate its centrality in his emotional life, but it is a secret that he has guarded closely and that has kept him feeling guilty and tortured.

The action in “The Fitful Sleep of Immigrants” takes place pronouncedly against the backdrop of the Bay Area. The specificity of the locations is such that I pity the Chicagoan trying to make sense of the dozens of geographic references — or perhaps envy the reader who can apply her imagination to the task.

But more significant than the place is the time. The novel is set in 1997, which is 18 years before the national recognition of same-sex marriage. While immigrants could be protected from deportation through marriage to a U.S. citizen, such options were not available to people in same-sex partnerships. As a direct result of both the immigration and marriage policies, Marc is faced with the possibility of having to become an immigrant himself if he is to remain in a union with the man he loves. As his immigrant father pines, “It never ends: our ancestors, my grandfather, my father, me, and now my son.”

This is Ortega’s fourth book of fiction. His first, a book of short stories called “Jerusalem Ablaze: Sto­ries of Love and Oth­er Obsessions,” likewise reflects his interest in exploring themes around Judaism and Israel.

His latest book is made more poignant by the reality of the author’s own life. Ortega-Medina, who is Sephardic, shares Marc’s Cuban/Syrian Jewish background and also practiced law in San Francisco in the 1990s. He notes in the acknowledgments that he and his life partner, an immigrant, left the United States in 1999, “having been ejected from the country of my birth due to marriage inequality.”

They settled first in Canada and then in London, where they still reside. While we might now take the right to marry in the United States for granted, it’s important to recall how recent a development it remains and how high the cost of its denial can be.

Although few books would dare introduce as many issues as “The Fitful Sleep of Immigrants,” the novel is nevertheless a compelling page-turner. I particularly appreciate Ortega-Medina’s deft handling of its pronouncedly imperfect protagonist, who, though tasked with narrating his own story, has much to learn about himself.

“The Fitful Sleep of Immigrants” by Orlando Ortega-Medina (335 pages, Amble Press)