Herbert Marx, November 11, 2019

Title

Herbert Marx, November 11, 2019

Subject

Air Reconnaissance
Albany Medical Center
American Heart Association
Bassett Hospital
Cardiology
Cooperstown, New York
Columbia University
Diagnosis
Electrical Engineering
Electrocardiography
Expansion
Foreign Medical Graduates
Formal Cardiology Program
Hazeltine
Jamaica, Queens
Little Neck, New York
Medical Resident
Medical Student
New York City
Otesaga Hotel
Patients
Rensselaer Polytechnic Institute
San Francisco
St. Albans, New York
Technology
Treatments
University of California
University of Rochester
University of Washington in Seattle
Healthcare

Description

Dr. Herbert J. Marx is a retired cardiologist from Cooperstown, New York. Born in Queens, New York, he attended school there until moving to Troy, New York to attend college at Rensselaer Polytechnic Institute where he studied electrical engineering. Following that he attended medical school at Columbia University. He spent time training and working at the University of Washington in Seattle, University of California in San Francisco, and the University of Rochester before moving to Cooperstown in 1971 to begin work at Bassett Hospital. He worked at Bassett Hospital in Cooperstown until his retirement in the 1990s. Today he continues to teach medical residents at Bassett how to interpret electrocardiograms.

In this interview Dr. Marx recalls his academic trajectory and talks at length about his decision to change career paths in order to become a cardiologist. Some of the topics discussed were his time growing up in New York City; his first job after college with a company working on air reconnaissance electronic equipment; his time as a medical student, resident, cardiologist and teacher; and memories of his time in Cooperstown.

I interviewed Dr. Marx at the First Presbyterian Church of Cooperstown where he is an active member of the congregation, although this part of his life was not discussed in the interview. His recollections were focused on his early life and career as well as reflections on his time at Bassett Hospital in Cooperstown, where he helped start the formal Cardiology Program, and advancements in his profession.

The transcript may very slightly from the audio. Some words may be added, adjusted, or removed, but this is solely for clarity when reading the transcript. Otherwise the transcript is not altered. I have not adjusted grammar that would alter Dr. Marx’s voice, but have made some amendments, again, for clarity.

Creator

Carolyn Caza

Publisher

Cooperstown Graduate Program, State University of New York-College at Oneonta

Date

2019-11-11

Rights

Cooperstown Graduate Association, Cooperstown, NY

Format

audio/mpeg
27.4mB
audio/mpeg
27.4mB
audio/mpeg
2.93mB
image/jpeg
7.03mB

Language

en-US

Type

Sound
Image

Identifier

19-003

Coverage

Upstate New York
Cooperstown, NY
1932-2019

Interviewer

Carolyn Caza

Interviewee

Dr. Herbert Marx

Location

First Presbyterian Church
Cooperstown, New York

Transcription

HM = Herbert Marx
CC = Carolyn Caza

[START OF TRACK 1, 0:00]

CC:

This is Carolyn Caza interviewing Dr. Herbert Marx on November 11th, 2019 for the Cooperstown Graduate Program’s Research and Fieldwork course, recorded at the First Presbyterian Church in Cooperstown, New York. Would you mind stating your full name and then when and where you were born?

HM:

Yes, my full name is Herbert John Marx and I was born on July 20th, 1932 in Queens, in New York City, in an area that was called Jamaica and grew up in St. Albans, Queens.

CC:

Alright, and could you tell me about growing up in St. Albans, Queens?

HM:

At that time, it was the far eastern border of Queens and that was largely a residential area but there was still some farming areas around us—I guess you would call it semi-rural. During the time that I lived there the farms were replaced by additional suburban housing, but it was still an area where it was easy to walk, and we would have to take a bus to get to Jamaica to get onto the New York City Subway system. The particular area of Queens in which I grew up was called St. Albans, and that was notable mainly for a navy medical hospital that was located to the west of us in towards New York City.

CC:

And what was your school like, can you talk about school?

HM:

The grammar school that I was involved with was at the other end of the city block that our house was on, it was Public School 136, and then the high school I attended was almost a mile walk away, but most people did walk—most of the students anyway—walked back and forth. That was called Andrew Jackson High School. It was a rather large high school; it had almost five thousand students in it. The change from public school to high school required some adjustment to the size of the classes and the whole size of the school.

CC:

How did you feel going to such a large school?

HM:

It was I guess expected and accustomed so there wasn’t any surprise about that, and the feelings among the students was that of a friendliness not a rivalry, so I was okay with that. I did well in my studies, once I adjusted in the first year to the size of the classes and things. I enjoyed a number of teachers that I had very much; they were really quite interested in the students. I don’t mean to boast, but I did graduate as the Valedictorian of the class and that was something that my family was very pleased to see.

CC:

Can you tell me more about your family, because I know you said your parents both came from Germany?

HM:

Yes, my parents both came from Germany after World War I when there was an economic instability in Germany. They came in around 1921. My father was a bricklayer and stonemason in Germany and was able to find employment here with the housing growing and other buildings—development in Queens around where we lived. In fact, one of the companies he worked for built the houses that I lived in after we moved from Jamaica to St. Albans. My mother worked as a kind of a house cleaner and nanny for some families. I should say that my mother and father immigrated in different years. There was a system—a person had to be sponsored and I’m not sure if there were quotas then, but my mother immigrated first, and she had an uncle and an aunt who lived in Brooklyn and lived initially with them and found employment working for a well-off family in Brooklyn. One of her brothers who had immigrated before she did was able to sponsor my father to come the following year, and then they got married in Brooklyn and settled in Jamaica. My older brother was born in Jamaica, as was I four years later, and then the family moved to St. Albans where my brother and I grew up.

My brother was the first person in our family to go to college. He went to CCNY, City College of New York, which required his taking a bus to the subway and then the subway into Manhattan to go to school. When I graduated my fallback plan was to go to a city college, but I was fortunate to receive scholarship assistance to go to Rensselaer Polytechnic Institute in Troy, New York, which was an interesting experience. I had very little experience living outside of the greater New York area so my first visit to Troy, New York was to go there by bus, and that was my first encounter—getting accustomed to the city—was when I arrived to go to college. There were still some temporary metal buildings that had been put up during World War II to house military service personnel who were stationed at the college and those became the freshman dormitories. The freshman dormitory that I lived in then had about ten or twelve students in each of these metal buildings. The college undergraduate enrollment at that time was about two thousand, which was less than half of the enrollment in the high school that I had gone to. There wasn’t a big size and population adjustment going from high school to college, but certainly the academic level was at a higher—the demands on the students were higher than in high school. I wasn’t sure what kind of major I [wanted to] enroll in. I was interested in science and our family orientation was a practical one of learning things in college that would help one be able to get a job and earn a good salary. And engineering at that time was an area that I was advised [of] by our high school advisor, and it looked like it had a very promising future, so that’s what directed me towards going to RPI. I was interested in a number of areas of science but decided that electrical engineering would be my major.

CC:

Can you tell my what your first job was after college in engineering?

HM:

Yes, my first job was dictated by a change in my father’s health. He had been quite healthy up until the time I was a college senior and I had been planning to go take a position with IBM in the Binghamton area. But several months before I graduated my father had a heart attack and I wasn’t sure how he would be doing and how well my mother could manage. So, I decided not to start work at Binghamton but went instead to a position as a junior electrical engineer for a company in Little Neck, New York. I don’t think that company exists anymore, but it was called Hazeltine. It was involved with working on air reconnaissance electronic equipment. To get from where my parent’s home was to go to work required either having a car or taking a variety of public transportation. For the most part I was able to be part of a carpool so I had the good fortune of someone who would pick me up at home and drop me off at the end of the workday at home.

CC:

How long did you work at that company for?

HM:

For somewhat over about two and a half years. Part of the activity was involved in an experimental program that was based in the Boston area, in Lincoln, Massachusetts which was outside of Boston. It involved an air reconnaissance site that was developed by a team from MIT, from IBM, from Bendix and from Hazeltine. The part that I was working on had to do with visual displays, so for a good part of the time that I was with the company I split time between the site in Little Neck and the site in Lincoln, Massachusetts. By that time, I had made a career decision—switch—deciding to go to medical school. So, part of that time I went to night school or summer school at Columbia University to take some additional biological and biochemical studies to meet the prerequisites for medical school. So that was a fairly busy time.

CC:

Can you tell me why you decided to make the switch from engineering to medical school?

[TRACK 1, 0:15:53.3]

HM:

Yeah, I had really decided that before I graduated from RPI. I found the basic science parts of my studies at RPI very interesting. But as we got into the more specialized electrical engineering studies, and I got a better view of what that would entail as a career, I felt that I really preferred, or I thought I would prefer, working more with the application of science to people rather than the application of sciences to military or commercial equipment. So, I decided to make that switch. It was a financial decision to work for a while before applying and starting medical school. Although I had scholarship help while I was at RPI, I really needed some additional funding to get started with medical school. Looking back, I think that was really consistent with what I enjoyed or felt gratification doing—the opportunity to learn about medicine and working with patients and various aspects of that. So, looking back I think that, although it was not an easy decision, it was the right decision for me as a person.

CC:

So, you decided to go to Columbia, and you took night classes. Can you tell me about your time at Columbia?

HM:

Yeah, I worked in the daytime as an engineer and then went to school in Manhattan at Columbia for some of my classes. I was able to take off a block of time in the summer after my first year of working there to do a more intensive biochemistry class. I met some interesting people who were taking night classes or summer school classes for other reasons than going to medical school, and that was an interesting experience. I particularly became friendly with a person from Connecticut who was taking classes to go to medical school and who invited me to visit with his family who had a property in Connecticut, which was a nice respite or diversion from some of the other things that we were working on. That was a good academic experience for me, and I learned that there was a different vocabulary in biological sciences than I had encountered in physical sciences and engineering, which was probably the most difficult part of that adjustment phase.

When I had completed those studies, which met the prerequisite requirements for going to Columbia Medical School, I was fortunate to be able to start there in 1956—at Columbia Medical School. By that time, the time that I’d finished my premedical and engineering work, my father’s health had improved, and he was back to work, and so I was able to go ahead with that next step in my career planning.

CC:

So, what inspired you to go into cardiology, specifically?

[TRACK 1, 0:21:34.8]

HM:

Cardiology has been a part of medicine that has used a lot of technology in its diagnostic and therapeutic phases and I was drawn to that—to applying some of the information and approaches that I had learned at RPI and working as an electrical engineer for two and a half years. While I was in medical school the first summer we didn’t have classes and I was able to have a summer job with a different engineering firm on Long Island that was involved in biomedical work, applying technology to medical problems, and that sort of backed up or reinforced the feeling that I had that cardiology would give me the opportunity to work as a physician to relate to patients, and that I would be able to do that. I would have that certain…I’m searching for a proper word to say that, but my engineering familiarity with equipment would facilitate some of my involvement with advances in cardiology care and so it seemed like a good way of bringing together some of the training that I’d had as an engineer and the training that I was receiving as a physician.

CC:

Can you tell me a little bit more about your career in cardiology, your first residency?

HM:

Yes, I graduated from Columbia Presbyterian College of Physicians and Surgeons and was fortunate to be selected as a medical intern candidate at Columbia Presbyterian Medical Center. I worked there as a medical intern and was asked to stay on as a medical resident. While I was in my first year of medical residency, I became acquainted with a number of people in the cardiology area. They made me aware of a program at the University of Washington in Seattle that was using a combination of biomedical and technical equipment to explore new areas in cardiology. Two of my co-residents, well actually they were one year ahead of me, moved from Columbia Presbyterian to the University of Washington in Seattle. One of them had been an undergraduate at the University of Washington and the other was someone who had trained at Columbia, but they kept in touch with me during their first year at Washington and spoke very positively of the residency program there. I applied for that, and also applied for that biomedical engineering fellowship, and it turned out that I was accepted for both. So, after my first year of internship and first year residency at Columbia Presbyterian, I went to Seattle for a second year of medical residency and then the biomedical engineering program for two years, and then received additional clinical cardiology training at the University of California in San Francisco. By then I had gotten married to someone that I met at Columbia Presbyterian Medical Center, someone who was a nursing graduate there, and we decided that since both our families were back in the Northeast that we would move back to somewhere in the Northeast. I was fortunate to receive a position at the University of Rochester Medical Center, with the cardiology group there, so that’s what brought us back from Seattle then San Francisco to the Northeast. Then I moved from Rochester to Cooperstown in 1971.

CC:

So, what brought you to Cooperstown?

[TRACK 1, 0:28:31.0]

HM:

It was a number of unplanned circumstances. A close friend of mine in the medical program at Rochester was finishing a fellowship in radiology and decided to come to Cooperstown and be interviewed for a possible attending physician position here. He invited me to come along for the ride. I was familiar with the Bassett Hospital and Cooperstown from my classmates at Columbia Medical School, because there was an affiliation between the two institutions, and some of my classmates came to Cooperstown from Columbia in New York City for electives during medical school. I did not come for an elective, but I did talk to them about their

[START OF TRACK 2, 0:00]

experiences here which were positive. When my friend at Rochester decided to come here for an interview, it was an opportunity for me to come along with him and get to see Cooperstown and the Bassett Hospital. Which I did. It turned out in addition to wanting to recruit my friend, they also were recruiting for other positions including someone to come as a cardiologist. The Chief of Medicine at that time and I talked on my visit. He was a very charismatic person and had explained the plans for developing the medical program at Bassett. It turned out that my friend did not accept the position here, but the Chief of Medicine kept in touch with me. After about a year later I made a decision to move from the Cardiology program at Rochester and come to Cooperstown and start up a formal Cardiology program at Bassett Hospital.

CC:

So, there wasn’t a program before you came?

[TRACK 2, 0:02:07.0]

HM:

There was no one who was a board-certified cardiologist on the program, so yeah, but there were people in the medical department who were doing [cardiology] but they hadn’t been trained in a cardiology program. In a sense I got a formal program going, but people had been cared for, for cardiology problems before that, yes. The following year I was able to recruit one of the people that was being trained at Rochester while I was on the staff there to join me in the cardiology program. The first year I was the only person here doing full-time cardiology work.

CC:

What was that experience like?

HM:

We had two little children and a third one was born that year, and so it was a very busy time. Essentially, I was on call all of the time, so I was very relieved and happy when I was joined by a second person in the program. But I had a lot of support from the other medical attendings that had been here before I joined the Bassett staff.

CC:

Was the hospital going through a sort of expansion of its programs when you joined?

[TRACK 2, 0:04:10.9]

HM:

Yes, during that time the building that’s now the hospital building opened when I was on that visit with my friend from Rochester. The building was in its final stages of construction. That following year the hospital part moved from what’s now called the “Old Stone Buildings” over to the hospital building, and the areas in the Old Stone Building were expanded into outpatient, laboratory, and clinical support space. That was a big expansion for them. Sometime later the clinic building [with] outpatient clinics was added to the Bassett facility—the medical center facility, but it was a period of considerable expansion and people coming in in other medical sub-specialty areas.

CC:

Can you tell me a little bit more about your experience as a cardiologist working here in Cooperstown?

[TRACK 2, 0:06:02.5]

HM:

You mean in contrast to working other places? One of the things is that we were able to provide medical care for Cooperstown area residents, people who lived in Cooperstown and the surrounding areas, we were also a referral center for people from quite a distance away. That was somewhat similar to Rochester, although most of the patients that we cared for at the University of Rochester were from the Rochester Metropolitan area. There were some who came from some distance, but I really felt that people who had travelled an hour or more to get to cardiology care at Cooperstown—I felt a responsibility to provide the best care we could and as effectively as we could since many of them had travelled long distances to get to our care. But otherwise, the types of patients that we saw and the cardiology problems that they had were very similar to what we had encountered or been involved with in Rochester. We did have the opportunity to work with cardiologists at Albany Medical Center to provide backup and diagnostic and therapeutic opportunities for patients that we couldn’t provide in Cooperstown. That was a very nice working relationship that we were able to have at that time.

CC:

How had the treatments been changing over time since you came to Cooperstown, in cardiology?

HM:

Well technology and cardiology have continued to advance together over that period of time so that there are more complicated, specialized techniques of diagnosis and treatment so that sub-specialization in medicine has moved to sub-sub specialization. In terms of electrophysiology and other areas in cardiology—coronary artery stenting—there continue to be continued technological advances to diagnose and treat patients that we could not do when I started out in cardiology. It also makes a challenge to decide which of these areas can be provided at top-level care in Cooperstown or when to refer patients to larger medical centers, such as at Rochester or in Albany, for their care.

CC:

Were there any challenges that you faced introducing new technology to the patients in the area?

HM:

I guess training technicians to be involved with that was part of the program. We would usually be working with people who were talented and dedicated but not trained to assist in some of the areas, like as we got into echocardiography and other areas in cardiac catheterization. So, the availability of trained nursing and technology personnel was a challenge, but we were fortunate in being able to have people acquire those skills and work in those positions.

CC:

So, you moved around a lot before coming to Cooperstown, what made you stay in Cooperstown for as long as you did?

HM:

The opportunities to work at Bassett Hospital is what drew me to Cooperstown. Cooperstown was the smallest size community that I had lived in, previously having lived in the New York City area, Seattle, San Francisco, and Rochester. That was an adjustment, but it was an adjustment that I enjoyed. Cooperstown was a very neighborly place. Main Street had an assortment of stores, a vegetable market, a grocery store and such so that things were close at hand. The community and the churches in the community were all very openly warm and involved us—my family. It seemed like a good place for my wife and me to live and for our children to grow up going to Cooperstown school, and kind of a contrast to my living in the New York City area where buses and subways were part of getting around to other places. Often things are accessible by walking or bicycling in Cooperstown. Academically I felt that things were at a level in Cooperstown that were comparable to the bigger medical centers, maybe not in terms of scope but in terms of quality.

CC:

So, you taught residents here yourself at Bassett, can you tell me about your experience teaching new residents?

[TRACK 2, 0:15:23.5]

HM:

One of the things that impressed me in moving from Rochester to Cooperstown initially was the quality of the medical interns and residents, and many of them would go to other hospitals in community medicine settings, but quite a few went to become specialists in different areas. Quite a few of them came back and became part of the Bassett medical staff after they’d had specialty training elsewhere or a number came back to join the medical or surgical staff after working at other larger centers. The quality of the personnel was really quite good. As the years progressed there were fewer U.S. medical graduates who were attracted to come to Cooperstown for training, so an adjustment that was made was to attract foreign medical graduates and that was an interesting experience. I’ve been impressed with the quality of most of the foreign medical graduates that I’ve had an opportunity to work with. So that was a new experience compared to the places where I’d trained where there were relatively few foreign medical graduates, and the first years in Cooperstown. This is something that probably started changing in the 1990s and since then.

CC:

Can you tell me about how they were able to attract the foreign medical students?

HM:

I didn’t personally take part in this, but initially there were members of the medical staff who went to medical schools in foreign countries that were known to have good medical school training and where there were a number of graduates who tended to apply to medical schools in the United States. So, there was a plan that was worked out in the Medical Education Department to seek recruits from other countries and once that got going the word got back from the residents who had come to Cooperstown and had a good experience here, which made it easier then to recruit additional medical graduates from some of those foreign countries. I don’t know how many different countries have been represented in the Bassett residency training, but I would guess that it’s probably fifteen or more different countries from which people have come.

CC:

So, have you been retired for a while, and can you tell me what teaching you still do with Bassett?

HM:

Yeah, I’ve been retired from the end of the 1990s. I was involved with some clinical research while I was working as a full time cardiologist and initially was asked to stay on and be involved in research programs that were going on. So, I’ve retired from full-time clinical practice and was involved with mentoring residents and research programs and participating in some other research programs and was asked by the Chief Residents if I would be interested in continuing to help train residents in interpreting electrocardiograms, which I did. The research activities have gotten progressively less as the research focus at Bassett has changed more into epidemiologic research in the communities. There’s been less in the way of clinical and biochemical type research, although there’s still some. My teaching initially also involved medical students in teaching Cardiac Physical Diagnosis as well as the basics of electrocardiography to medical students. These students come from Columbia Medical School where they get their basic training and that aspect of their training has now moved to occur at Columbia Medical School in New York City so we’re not doing that during their time in Cooperstown. About two years ago I stopped—because of the change in the medical student curriculum, I no longer am teaching medical students, but I continue to teach medical residents in interpreting electrocardiograms and do that on Mondays with a group of first-year medical residents and then a second group of second- and third-year medical residents. I appreciate the opportunity to continue to be involved with medical residents, it’s a stimulating experience for me to continue to be able to do that.

CC:

Can you tell me a little bit more about the experience you have with the residents?

HM:

Could you clarify that a little bit?

CC:

Yeah, you said the experience is really stimulating—

[TRACK 2, 0:24:10.4]

HM:

Well, I’ve learned a little bit about the various countries they come from, and their thoughts about medical training in the United States, and it’s been interesting. We don’t talk—in the time that we have for training—a lot about their experiences in the foreign country in which they’ve grown up, but a little bit so that it’s enlarged my horizons of medicine around the world. It’s been interesting to become acquainted with medical personnel who have had a different background than my background, that’s I guess the main thing. It’s also been interesting to me to see how well the residents from the various countries work with each other, even though their native countries may not be in the best relationships. That has been a gratifying thing to see—interpersonal relations working so well with them.

CC:

So, we’ve just got about four minutes left are there any other stories from your time here in Cooperstown that you’d like to share? Or memories? Possibly your involvement with the First Presbyterian Church?

HM:

Yeah, I was thinking about—with the snow that we had—my first year here there was a snow experience which I still remember fairly vividly. The Chief of Medicine, the first year that I came here, was involved with the American Heart Association chapter that included Cooperstown, it was based in Utica. That chapter was part of the New York State affiliate of the American Heart Association which had statewide affiliates. After I arrived here, he told me that he had invited a New York State affiliate to have its statewide annual meeting in Cooperstown the following spring, in May, and asked me to be involved with the logistics of setting that up, which I did. Then, unfortunately, he left Cooperstown in the spring of that year so the responsibility for that statewide program moved from him to me. It was I think the second or the third week in May, and we had a good turnout—the program was at the Otesaga Hotel—but the weather was not what we expected for May. We had quite a snowstorm and the trees by then were in full leaf, and a lot of the limbs couldn’t stay up with the snow fall, and so electrical lines came down and there was no power. When I woke up and looked out on the first day of the meeting, I saw all of the snow, more than what had been forecast, and we had power at our house but when I got over to the Otesaga I discovered they did not have power. But the staff at the Otesaga responded amazingly; they were able to prepare breakfast for the delegates from all around the state. At that time people didn’t use PowerPoint projectors but they used slide projectors. The slide projectors couldn’t function because there was no power. There were no lights in the rooms, but the room allocations were shifted around so that the sessions were held in rooms where there were enough windows and daylight so

[START OF TRACK 3, 0:00]

that people could see. The speakers from around the state, experts in various areas, adjusted to presenting their information with blackboards and written things on bulletin boards rather than slide presentations. The cooperation of the staff at the Otesaga was amazing and the adjustment of the people who had come to Cooperstown expecting to be at a May, spring meeting—it was a very friendly give and take atmosphere. It turned out to be an amazingly successful meeting, despite all of this. We were reminded that gas pumps at service stations also required electricity and they couldn’t function either so people who needed to fill up their cars with gas to go home after the meeting was finished had to wait over another day before they could do that. I continued to be involved with the Heart Association after that first year and that statewide experience and became President of the Central New York Chapter that was the sponsor for this and then President of the state affiliate. I was reminded many years afterwards when I would go to Heart Association functions by people who had had that experience in Cooperstown. So that was a part of my learning development moving to Cooperstown that I don’t think I’ll ever forget.

I don’t know if we have time for any other anecdotes or experiences, but that was one that I was reminded of this past week when we had the early snowfall here.

CC:

Right. Well we’re just a little bit over an hour so I don’t have any more questions, if there’s nothing else you want to add? Thank you so much for sharing your story with me.

HM:

Well I guess I don’t have any other questions, I’m not quite sure how much time we have.

CC:

I think we’re all set but thank you so much for speaking with me.

Duration

00:29:59 - Track 1
00:30:00 - Track 2
00:03:12 - Track 3

Bit Rate/Frequency

128kbps

Time Summary

Track 1, 00:15:53 - Career Switch
Track 1, 00:21:34 - Cardiology
Track 1, 00:28:31 - Moving to Cooperstown
Track 2, 00:02:07 - Formal Cardiology Program at Bassett
Track 2, 00:04:10 - Expansion of Bassett Hospital
Track 2, 00:06:02 - Cardiology in Cooperstown
Track 2, 00:15:23 - Teaching New Medical Residents
Track 2, 00:24:10 - Learning From the Medical Residents

Files

Dr. Herbert J. Marx Photo.JPG

Citation

Carolyn Caza, “Herbert Marx, November 11, 2019 ,” CGP Community Stories, accessed August 7, 2020, http://cgpcommunitystories.org/items/show/407.