What happens to Raymond? How does this affect the family

Pablo and Ramona have a son after several daughters, and they name him Raymond after his mother. But, Pablo leaves again, and Ramona has to work, leaving her youngest children in the charge of her eldest daughter, Esmeralda herself. Eventually, they accidentally hurt Raymond, and the doctors suggest amputating the babies leg, prompting Ramona's first journey to New York City to get a second opinion.