Ajaccio salt flats near his birthplace, he’d come down with a serious fever, but he had survived with no aftereffects. While stationed in Auxonne as a poverty-stricken junior officer, Napoleon had survived a bout of malaria while still managing to put in eighteen hours of study every day. A second wave hit after the first had subsided, and Napoleon blamed it on the miasme (or “bad air”) from a river close to his lodgings. Still, he worked furiously through the headaches and pain. “I have no other resource but work,” he wrote. “I dress but once in eight days; I sleep but little since my illness; it is incredible.” For the young Corsican—penniless, friendless, obscure but driven—those days were his refining fire. Disease had been just another test. Why couldn’t other men overcome it?
Instead of physicians he believed in portents, lucky omens, as any true Corsican of the time would have. March 20 and June 14 were particularly good days for him; he hated Fridays and the number 13. He had a “familiar” called Red Man, a conduit to his lucky star, which visited him only on important occasions. In Egypt, the Red Man had told him that success was guaranteed despite his reversals, and in Italy, at Marengo, the spirit assured him that he was soon to be emperor of France. As he contemplated the invasion of Russia, the ghost had appeared to him and told him the war was a mistake, but after considering the warning, he disobeyed. To rebel even against the spirit world would prove he was equal to the gods themselves. “I’m trying to rise above myself,” he confided to his officers on the campaign. “That’s what greatness means.”
Later in his career, he learned to use disease. When the English took the island of Walcheren off the coast of the Netherlands in 1809, he refused to send his troops in. “Walcheren has for its defense fever and poor air,” he told his marshals. “In this season the island is one of the unhealthiest places on earth.” The British fell in droves to Walcheren fever, a mixture of dysentery and assorted fevers. “Health is indispensable in war” became one of the emperor’s maxims.
Napoleon had actually overseen a host of advances in war medicine, including Larrey’s invention of the “flying ambulance,” which, combined with his insistence that doctors bring their field hospitals close to the lines of battle, reduced the time that doctors could reach and treat wounded men from many hours to fifteen minutes. (For these innovations, and his policy of treating enemy wounded in the same way he treated French ones, Larrey is often considered the spiritual father of the modern Red Cross.) The doctor was genuinely loved by the soldiers; when in 1808 a rumor shot through the Army of Spain that Larrey had been killed by enemy fire, the troops of the elite Imperial Guard broke down and swore to avenge him. The rumors turned out to be untrue.
But when it came to funding his army, Napoleon’s prejudices came through. On the Russian campaign, the surgical corps was a shell of its former self. Young men unfit for army service, the dregs of the French population, could get an appointment as a junior regimental surgeon after only three months at a medical school. One medical student remarked on how many of his classmates were “hunchbacks and cripples.” Napoleon had systematically cut at the control that doctors had over their own work, handing supervision over to bureaucrats and even stripping physicians of the epaulettes they had worn on their uniforms. A significant portion of his doctors were regarded as cowards, malingerers, or hacks.
T HE F RENCH HAD FACED the killer that was gathering power in its ranks before. It had struck the French army during the wars in Spain (where 300,000 of Napoleon’s men died of disease, and only 100,000 in battle). The pathogen had aided them immensely at the siege of Saragossa in the summer of 1808, when 54,000 of the city’s 100,000 citizens died