ABSTRACT
From the inception of ECT, patients and doctors have expressed concerns about possible cognitive side effects, especially memory loss. 3 Denials that such losses are common are just as old.
Permanent, long-term retrograde memory loss-the loss of already acquired memories-is the most serious possible side effect of modifi ed ECT, but there is controversy about how common it is. Some clinical handbooks describe the risk of this side effect as minimal. 4 Many scientifi c studies have shown such loss to be possible, but there is no agreement on how common it is. Published narrative accounts of ECT treatment-both positive and negative-refer to major permanent losses in memory more often than they do not. A puzzle is posed: if permanent memory loss from ECT is as rare as many scientifi c studies claim, why is it so common in narrative accounts? This chapter will examine the history of this side effect by juxtaposing scientifi c studies and narrative accounts. Just as the history of therapeutics has raised questions about how to regard changing views of effi cacy, I raise analogous questions about side effects. Just as effi cacy is related to historical context, the meaning and signifi cance of side effects are also historically variable. 5 The idea of a side effect may itself be an unintended side effect of the rise of therapeutic specifi city in biomedicine.
