Now, I'm loath to make diagnostic pronouncements from a distance, and I believe it's borderline unethical, but entitlement is not a diagnosis, so I'll give vent to my anger and consider the case of Martha Coakley, Democratic candidate in tomorrow's election to take over the seat formerly held by Edward Kennedy.

All portents point to a Coakley loss, and the circumstantial evidence points to a sense of psychological entitlement.

When she won the Democratic primary on December 8, 2009, it was only six weeks to go before the general election scheduled for tomorrow, January 19, 2010.

It was easy for her to believe she would win--would be entitled to win--the general.

Obama won the state by 26 percentage points. In only four states did he have a greater margin. Ted Kennedy held the senate seat for 46 years and pretty much glided to victory in nine elections. At the time of the primary, Coakley held a 31-point lead over her Republican opponent, Scott Brown. And only about 12 percent of the voters in Massachusetts are Republicans.

And most egregiously, in Massachusetts, she called Curt Schilling, a Yankee fan! He, the bloody-sock hero of the 2004 American League Championship against the hated Yankees. Schilling, a Republican, is making mocking anti-Coakley robocalls in the run-up to the election.

I guess if you have a sense of psychological entitlement, that kind of back-story will make you secure in your entitlement.

How else besides psychological entitlement can we think about these facts?

Coakley opened two field offices to Brown's nine.

Coakley didn't run her first campaign ad until after Brown ran two.

And most egregiously, Coakley took a week's vacation during Christmas, only weeks before the election.

Contrast that to my state, Connecticut. Yesterday, I attended a dedication ceremony for my son's new middle school building. Not on the announced guest list was Richard Blumenthal, Connecticut's Attorney General, and the likely Democratic candidate for senate in November. His margin in the current polls puts him about 40 percentage points ahead of any of the three Republican nomination contenders. Yet he showed up for the event in my small corner of the state. Maybe he was chastened by the news reports of his fellow Attorney General, Martha Coakley, but if he had a sense of entitlement, he disabused himself of that notion, and realizes that someone in yesterday's audience may be just the vote he needs to win.

As Woody Allen said, "Eighty percent of success of showing up," and people who are entitled think they can be no shows.

Why is this important?

Scott Brown pledges to be the 41st vote supporting a Republican filibuster against health care reform in the Senate. Under the expected scenario, health care will go down if the Democrats don't have 60 votes.

I was 48 when health care failed under Clinton in 1994. As these things go, I will be 80 when it comes around again.

I have great private health care now, and I will have great government health care, Medicare, next year when I turn 65. So I have no personal cares about the coverage for myself or my family. But I care about the 45,000 people who die each year from lack of coverage.

All thanks to one person's sense of psychological entitlement.

As that great psychologist and sometime baseball player, Satchel Page (after whom Woody Allen named his son) said, "Don't look back. Someone may be gaining on you."

Or as they used to say when I lived in Mayor Daley's Chicago: "Vote early and often."

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Click here to read the first chapter of my book, Nasty, Brutish, and Long: Adventures in Old Age and the World of Eldercare (Avery/Penguin, 2009). It provides a unique, insider's perspective on aging in America. It is an account of my work as a psychologist in nursing homes, the story of caregiving to my frail, elderly parents--all to the accompaniment of ruminations on my own mortality. Thomas Lynch, author of The Undertaking calls it "A book for policy makers, caregivers, the halt and lame, the upright and unemcumbered: anyone who ever intends to get old."

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