SQL Express 2008 R2 on Amazon EC2 instance: tons of free memory, poor performance
Decided to uninstall SQL Express 2008 and install SQL Express 2005.  Restored the database (same one I had originally backed up for the migration), load time for the one page was down to ~6 seconds from ~13 seconds.

Reindexed the database for fun and profit and checked consistency.  Seemed fine (return code 0).