Because Ramirez hadn't said anything to Francona in the morning or early afternoon hours about being unable to play, he was in the original lineup, batting fourth and playing left field.
But while Francona was holding court with the media roughly three hours before game time, Ramirez told bench coach Brad Mills that he couldn't play.
Francona came off the field during batting practice, flanked by principal owner John W. Henry and team chairman Tom Werner. Those three men, along with general manager Theo Epstein, Ramirez and members of the training staff, held a meeting in Francona's office. Shortly thereafter, Ramirez left Fenway Park and had an MRI performed on both knees.
The results? Negative.
Francona didn't have any more information than that.
"This was all happening right before, during the game. I would be able to give you a better answer tomorrow," said Francona.
The manager was asked if Ramirez came in during the day for treatment, as players with ailments often do.
"He came in to lift today," he said. "I don't know that I could give you our treatment schedule. I don't know if I really can do that. I don't think I'm supposed to do that."
Ramirez was spotted taking batting practice in the tunnel below the Red Sox dugout before undergoing the MRI.
Was Francona upset that Ramirez didn't make himself available against the Yankees?
"I think I've answered enough tonight," he said. "It's five minutes after the game. I'd like to talk to some of the medical people a little bit more extensively. There's time to answer questions about anybody. For me, right now wouldn't be it."
Before the game, Ortiz was bombarded by reporters, but he was content to let his bat do most of the talking for him.
"I'm excited. I'm back, that's it," said Ortiz. "I'll talk to you after the game."
As it turns out, Ortiz didn't come through on that promise, disappearing quietly following the loss.
Ortiz had been sidelined with a partially torn tendon sheath in his left wrist. He hit three home runs in a six-game Minor League rehab assignment.
As for Ramirez, Francona is hopeful he'll be recovered after sitting out the series opener.
There is no official diagnosis for Ramirez's injury.
"[It's the] same knee that was hurting before," Francona said. "He woke up and said he was sore. He said it had been bothering him four or five days, and he hadn't said anything to us about it. It happens to some guys."
Once Ramirez was scratched, the lineup got a makeover. Jacoby Ellsbury, who would have batted ninth and played center field, moved to the leadoff spot and played left. Coco Crisp, who wasn't supposed to start, got the nod in center and hit ninth.
Kevin Youkilis, originally in the No. 2 hole, batted in Ramirez's cleanup position. Dustin Pedroia moved from leadoff to second.
What most excited the Sox was the presence of Ortiz.
"He's done real well at [Triple-A] Pawtucket, so it's nice to see him feeling a lot better and swinging the bat well," said Ellsbury. "It never hurts to have David in the lineup. A lot of the guys stepped up and did a tremendous job. It's definitely going to help to have David back."
What were the Red Sox expecting from Ortiz?
"Just be David," Francona said before the game. "You can't push a button and make people hit. The guy tonight [Joba Chamberlain] is going to be throwing about 98 [mph]. He's got six games under his belt. We wouldn't play him if he was not supposed to play. You don't know if a guy is going to come out hot, cold, in between. But he's swinging the bat fine."