A deeply powerful, raw debut novel that's "equal measures hilarious and haunting" (Crystal Hana Kim), of a Puerto Rican family in Staten Island who discovers their long‑missing sister is potentially alive and cast on a reality TV show, and they set out to bring her home. The Ramirez women of Staten Island orbit around absence. When thirteen‑year‑old middle child Ruthy disappeared without a trace from the local bus stop, it left the family scarred and scrambling. One night, twelve years later, oldest sister Jessica spots a woman with Ruthy's distinctive birthmark on her TV screen in a trashy reality show called Catfight. She rushes to call her younger sister, Nina. The woman's hair is dyed red, and she calls herself Ruby, but the birthmark under her right eye is recognizable. Could it be Ruthy, after all this time? The years since Ruthy's disappearance haven't been easy on the Ramirez family. Their mother, Dolores, struggles with mental health, weight gain, and diabetes; Jessica juggles a newborn baby with her hospital job; and Nina, after four successful years at college, has returned home to medical school rejections and now works in the mall folding tiny, bedazzled thongs at the lingerie store. After seeing maybe‑Ruthy on their screen, Jessica and Nina hatch a plan to drive up to Boston where the show is filmed in search of their long‑lost sister. When Dolores catches wind of their scheme, she insists on joining, along with her best friend, Irene. What follows is a family road trip and reckoning that will force the Ramirez women to finally face the past and look toward a future--with or without Ruthy in it. Told in multiple brash, distinctive voices, and filled with humor and truth, What Happened to Ruthy Ramirez explores female familial bonds and cycles of generational violence, poverty, and silence in a world that allows little room for Brown women. This is a vivid family portrait, in all its shattered reality, replete with snark, impatience, resentment, tenderness, and, of course, love.