Alan Schom is very harsh in his treatment of Napoleon the character, a peculiar aspect of American and English biographies. His book is none the less an excellent read (I having only just finished it a month ago).

I'd say that as with all depictions of Napoleon the man, there is a grain of truth to it. Napoleon was on several occasions visibly shaken by carnage and at least attempted to show concern for his soldiers, famously riding out to care for the wounded and help triage them after Austerlitz.

The passage in question from Schom's book centers around, I believe, Napoleon's utter indifference during his early campaigns to the frustrations of his chief medical officer, particularly Egypt. The problem with any looks into Napoleon's character is that he is a complete enigma. For every act of barbarism there seems to be an equally sublime act on his part. Napoleon shrugged off the concerns of his medical officer in Egypt, true. He also visited and comforted his men who were laid to waste by the Bubonic plague when the doctors themselves wouldn't go near them. Its part of the mystery of Napoleon, as Chandler puts it 'a man who was neither bad nor good.'

If I had to give you a firm answer...let's say that Napoleon was not afraid to look at the Butcher's bill. He did not shie away from losses for any reason, had an iron will when accepting them and tended to focus so much on the 'here and now' than to focus on the 'peripherals.' He had Berthier and many other subordinates to take care of such minute details.

The first field ambulance system is largely attributed to Napoleon and goes hand in hand with his revolutionary Corps d'Armee system, which would be instituted only after his coronation. The difference between Napoleon in 1804 and Napoleon in 1796 in terms of rash action and ruthlessness is quite substantial, and its always good to note that Schom is often considered unduly harsh on his perception of Napoleon's character as well. Napoleon also cared famously for his veterans; they were the base of his power.

Finally try to bear in mind the era of warfare being discussed. Its easy for his opposites in Egypt, the Pashas and Sir Sydney Smith to ruin his character with the stories of his treatment and abandonment of soldiery in Egypt, but one can assert with some confidence that any other General would've been hard pressed to give serious medical attention in the more or less marooned circumstances of the expeditionary force. Finally, we are speaking of the late 1700s, medical care was more akin to butchery at best, and I always doubted Schom's grasp of context during the Egyptian phase of his book.

Sources in addition to Schom: "Campaigns of Napoleon" Chandler, David G. MacMillian Press, 1966.

"Swords around a Throne" Elting, John R. De Capo Press Inc, 1988.

Schom is...very unkind to Napoleon. Napoleon could be famously indifferent to the care of wounded, but he was far from unique in terms of other battlefield commanders of the era. The French medical service was actually far superior to most of its contemporaries for most of the Napoleonic Wars. the reforms of Dominique Larrey, who successfully appealed to Napoleon to create a systematized medical and ambulance care into formal battalions. The problem was that this reform could not cope with the increased scale and tempo of Napoleonic military operations. But these anemic efforts were far greater than many of France's contemporaries, whose efforts at establishing battlefield medical care was often underfunded. Only the British Army emulated and matched the French effort. This partly was a recognition on the part of Wellington and other British generals that the army was operating far from home and could not easily gain reinforcements.

This article by Xavier Riaud gives an idea for the French efforts at improving battlefield medicine.

As for the assertion that he refused to build hospitals for wounded veterans (i.e. soldiers discharged), that's not accurate. Napoleon expanded the ancien regime's hospital/retirement home system for disabled veterans (Les Invalides). However, like the battlefield medicine, these medical programs found it difficult to care for the sudden influx of discharged veterans.

The fundamental problem is that Schom is setting up rather unfair benchmarks to judge Napoleon's actions. Napoleon did not invest lavishly in healthcare both on and off the battlefield, neither did any of his contemporaries.

Sources

Muir, Rory. Tactics and the Experience of Battle in the Age of Napoleon. New Haven, Conn: Yale University Press, 1998.

Rothenberg, Gunther E. The Art of Warfare in the Age of Napoleon. Bloomington: Indiana University Press, 1978.

We have on record that he seems to have cared about at least one wounded enemy soldier, as I've had the chance to note before.

During the Battle of Waterloo in June of 1815, a young English officer named William George Keith Elphinstone was wounded and subsequently captured by the French. He had a number of distinctive qualities by both achievement and birth; he was at that time in command of the 33rd Regiment of Foot, but he was also son of the director of the British East India Company and nephew to Admiral Lord Keith.

In any event, his wounds were severe; he was brought before Napoleon, who instructed that his personal surgeon attend to the officer at once. He survived, though he would remain weak and sickly for the rest of his life, and was knighted for his actions during the battle upon his return to England. Napoleon may well have forgotten about him in the chaos of all that followed, and, then again, he may not -- but he would have cause to recall him later.