Radical empathy in extreme situations—double-binds, moral trauma, and soul murder—looks at how storytelling is needed to complete impossible predicaments confronting the human condition. Not solve them, but complete them, providing literary closure, leaving the reader whole and complete. The agent is put in a double-bind, caught between a rock and a hard place, risking perpetuating and undergoing moral trauma. In ethics this is called “the Trolley Car Dilemma” (which is defined). In literature this is called “tragedy.” Philoctetes, Antigone, Oedipus, Orestes, Phaedra, and virtually the entire House of Atreus, are actors confronting agency compromised by contingency. Contingency giveth and contingency taketh away. The empathic distress of the tragic dilemma requires standard empathy to become radical. Paul Tremblay’s novel The Cabin at the End of the World presents a narrative that, in its form, is similar to the overall structure of the Dilemma of the Trolley Car problem. With a story one gets inside the experience in a way that matters and which no logical puzzle can provide.