Lilly Caul on Ruthie:
- "The seven-year-old Ruthie—an adorable little elf with Shirley Temple curls hanging over the collar of her miniature ski jacket."
Nothing is known about Ruthie's life prior to or as the outbreak began, except that she resided with her parents and three sisters.
While Lilly is watching over her and her siblings, an unknown car is heard in the distance. Sarah grabs her and brings her into the circus tent to hide with her mother and other sisters. The car is later revealed to be driven by Bob Stookey.
While Lilly is babysitting her and her sisters, a small horde of Walkers attack the camp. Lilly and the girls are attacked, but manage to escape even after the circus tent collapses on top of them. Lilly grabs Ruthie and brings her to the closest girl while Sarah and the twins follow. Lilly locks Ruthie in the car, saving her. After Sarah is killed, Walkers begin to close in on the car. To distract them, Lilly bangs on other cars with a shovel, which draws the zombies towards her and away from the children.
After Tent City was destroyed by walkers and engulfed by flames, it is unknown what happened to Ruthie or her family. Lilly's group states that there were most likely no survivors.