What struck him right away was what was not there. Slides from a normal brain would be solid pink. Many of these were dappled with white spots that made them look like slices of baby Swiss or leaves eaten down to the veins. The white holes were the abandoned homes of dead cells.

The hippocampus was sparsely populated, with far fewer pyramid-shape neurons than normal. Even with this stain, not designed to show clumps of proteins, Forman saw his first tangles - dark, flame-shape interlopers flowing from some cell nuclei.

This was typical for Alzheimer's.

But in the brain stem, he saw something intriguing: planet-like circles with pale rims and dark pink centers.

These were Lewy bodies. Forman would expect to find them in the brain stems of patients with Parkinson's, but with more damage. This might mean that Moore's disease was more complicated than his doctors had thought.

Forman moved on to the next slides. These had been stained to reveal abnormal tau, the key component in tangles, by turning it brown. Slides from a normal brain would be all white, with a bluish cast. Moore's had a dark ribbon of brown on the edges.

"I call that my Alzheimer's disease diagnosis," Forman said. "I don't even have to look at the slide to know what the disease will be." He looked anyway and saw what he had expected: "wall-to-wall" pathology.

Curious about what he'd found in the brain stem, Forman now picked up the set of slides that stained alpha-synuclein, the protein in Lewy bodies, dark brown.

Developed in 1998, the stain has turned up Lewy bodies in many Alzheimer's patients, raising questions about this protein conglomeration's relationship with plaques and tangles.

In half of Alzheimer's patients, Lewy bodies are in the amygdala - the part of the brain key to processing emotions. In a quarter, the Lewy bodies are widespread enough to warrant a different diagnosis.

Doctors often miss this dual problem while patients are alive, probably because symptoms of the two dementias are so similar. But Lewy body dementia is more likely to involve hallucinations, sleep disruptions, fluctuations in thinking ability - plus the tremors and rigidity of Parkinson's.

Moore had not had movement problems, but he may have had some of the others.

Forman peered through his microscope and saw that Moore's amygdala was packed with Lewy bodies. The surprise, though, was how many Forman saw throughout the brain, particularly in the upper regions.

"This," he said, "is an extraordinary case of Lewy body pathology."

Finally, it was time for fluorescent slides that light up both the plaques and tangles of Alzheimer's in glow-stick green. The plaques - puffs of protein stuck together like popcorn balls - are seen best in these slides.

In a normal brain, Forman would see only black. The slide of Moore's hippocampus lit up like the Milky Way, chock full of oddly shaped fluorescent stars and twisting streaks.

"We know what the diagnosis is," he said.

Bob Moore had gotten a dementia double whammy. Separately, he had enough plaques and tangles - and enough Lewy bodies - to ruin his brain.

Brain 05-274 would have a new job now. It would join 900 others stacked on shelves in the lab, waiting to help scientists vanquish their killers.

The autopsy report