ABOVE: A steady accumulation of losses brought Tereza Sedgwick to the only house she could afford, an abandoned farm building with meager heat and sporadic electricity. There was her layoff from a furniture factory; the expiration of her unemployment insurance after 66 weeks; the eviction from her one-bedroom apartment; the loss of her cable TV, her cellphone and 50 pounds to stress. She had stayed at friends’ houses with her son, Sebastian, and worked whatever hours the local McDonald’s would give her. But before long she had exhausted her savings and her friends’ patience.

On her lap sat the textbook for the school's monthly nursing aide class, which she had finished reading two weeks early, filling the margins with handwritten notes.

"Most stable job ever!" read one.

"A world of opportunity," read another.

She had been awake the night before until 2 a.m. with a nervous stomach, and now she reached for a Xanax and swallowed it with the last of her Sprite. How long had it been since she entered a classroom? How many times in life could she summon the courage to start over? She was a few weeks shy of turning 30 - a single mother on the verge of eviction, with a 5-year-old son and a part-time job at McDonald's that paid $8 an hour. The run of failure that she so far had blamed on external forces - bad luck, the Rust Belt, economic collapse - was threatening to become internal, a self-definition she would carry forward into what she called "my actual, this-is-really-who-I-am adulthood."

"A NEW CAREER and a NEW YOU in just 75 classroom hours," a brochure for the nursing aide class had promised, and it was transformation she was after.

She grabbed her textbook and walked toward the career center, a concrete building set amidst the rolling farmland of Marietta. It was the oldest city in the state, 15,000 people pressed against the Ohio River, and its survival had always depended on reinvention: from agriculture to coal, from manufacturing to service industries. Now, two-thirds of the region's available jobs related to health care, and Tereza walked into a classroom cluttered with wheelchairs, portable toilets and hospital beds. There were seven other people in the room - all starting over in the tenuous, low-wage recovery of 2014, in which job retraining was no longer a qualification but a prerequisite, and careers were chosen based not on preference but on prescriptions of economic need.