Around the same time, health care jobs began to perk up, starting around 1981 when the fledgling UPMC recruited organ-transplant pioneer Dr. Thomas Starzl. Employment has since flip-flopped, with some 183,000 people working in health care today, roughly the same number who worked in manufacturing in 1984. Primary metals’ industries employed 86,298 people, or 9.2 percent of the region’s total workforce in 1980; today it’s 1 percent. At the same time, the region’s population shrank to around 2.3 million from 2.6 million in 1980.

UPMC President and CEO Jeffrey Romoff built the city’s hospital empire by providing delivery-room-to-deathbed care, much in the same way Andrew Carnegie built a vertically integrated steel giant here a century earlier by controlling every step in the production process. UPMC’s payroll has ballooned to 50,000 as the hospital giant plans for still more growth.

Romoff in August unveiled plans to build a first-of-its-kind vaccine factory to counter bioterrorist threats. The plant would leapfrog existing technology in speed and flexibility in vaccine development and eventually attract up to 70,000 jobs to Pittsburgh. If he’s successful, Romoff could become a latter-day Carnegie, running a biotech version of the electric-arc mini-mills that turned open-hearth furnaces, like ones on the South Side, into dinosaurs.

“The only significant problem in western Pennsylvania is that western Pennsylvania underestimates itself,” says Romoff, a New Yorker who has made Pittsburgh home for the past 36 years.

It’s a common refrain, even among Pittsburgh natives like Mary Murphy Kiernan, who with her husband, Bob, owns Actual Size Creative, a downtown marketing agency. The Kiernans moved to Washington, D.C., in 1994 for jobs, but returned five years later when both were 32 years old to be closer to family.

“We think all Pittsburghers have to leave for at least a year so they appreciate what they have,” Kiernan says. “We have so much development going on, great restaurants, great nightlife. Pittsburgh needs to hear good things about Pittsburgh.”

Pittsburgh’s self-image is part of its molten identity. In fits and starts, a new economy is taking shape, with eds and meds leading the way. Biotechnology seems like a natural fit, but it hasn’t taken off as quickly as might have been expected, given UPMC’s meteoric rise, Briem says. “There’s great talent here, but commercialization has been the challenge,” he says. More worrisome, the Pittsburgh region lagged behind the largest 40 regions in the country for new business formation in 2006, according to the Brandow Co., a research outfit.

Expectations for ourselves have always been modest, though. I loved those car trips along Second Avenue to my grandmother’s house in Hazelwood, a few miles upriver from the Hot Metal Bridge. Helen Kazmierski arrived in Pittsburgh from Poland as a child and later supported herself by opening a beauty shop near a rail yard. At night, she painted ballerinas on canvas in a cramped third-floor studio that was thick with the smell of turpentine.

Her dreams for her family were simple: something better than the hard life she’d known. I pedal the bike path along Second Avenue, remembering the little boy in the backseat of his father’s car, awed by all the smoke and flames. I wonder how my grandmother would view our city’s transformation, even as we sift details of the future.

“I don’t know where it’s going,” Hooper says, his dark hair tied in a long ponytail, when asked about Pittsburgh’s future. He’s peeling peaches with a paring knife, slender fingers coaxing pits from white flesh, which he says will be preserved and eventually used in a future signature dish. Steel was part of our past, he says, but only a part.

“We don’t have to let that define us,” Hooper says. “We can’t see Pittsburgh from the eyes of people who are far away. We have to see it through our eyes.”