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A few days before December 12, 2008, my sister Ruth Litoff decorated her Manhattan loft like a beautiful stage set with fifteen suicide notes surrounding her and specially selected gifts for her closest friends. Multiple bowls of cat food were left in case it took us awhile to find her and every one of her hundreds of markers was in rainbow order. The police officer whispered,  “I’ve never seen anything like this.”

The film begins on that day I found Ruth dead and traces over her fascinating life and work—punctuated by incredible highs and lows and secrets and lies. It follows my journey as I examine her rich body of artwork, interview friends and family, and read her journals for the very first time. She excelled at everything she did.  She was my hero. Why would she want to die?

Like a detective, I’m trying to piece it all together. But making the film has forced me to face difficult truths and caused me to drink again after 16 years of sobriety. The film raises so many questions.  Must I admit that my sister and I are not so different?  Will the process set me free or destroy me? 

- Hope Litoff


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The Filmmakers

Hope Litoff Director

HOPE LITOFF is a 20-year veteran film editor. 32 PILLS marks her directorial debut.  She began her career assisting filmmakers such as Ken Burns and Stephen Ives on THE WEST, as well as MISS AMERICA, dir. Lisa Ades (PBS) and BLUE VINYL, dir. Judith Helfand and Dan Gold (HBO). She went on to edit such verite projects as: KEEPER OF THE COHEN, dir. David Gaynes, COLLEGE BOYS LIVE, dir. George O’Donnell, and SEEING SALLY, dir. Peter Goodman, all of which played in multiple film festivals. Her television credits include CHASING THE CROWN (WE), THE WELL SEASONED TRAVELER dir. George Billard (A&E), and INDIE SEX, dir. Lisa Ades (IFP). She lives and works in New York City.

Beth Levison Producer

BETH LEVISON is an independent producer/director and the recipient of two national Emmy Awards and three Peabody Awards.  Prior to 32 PILLS, she produced THE TRIALS OF SPRING (2015), a cross-media project including a feature-length documentary (dir. Gini Reticker) and six shorts about women human rights activists in Egypt, Tunisia, Libya, Syria, Bahrain and Yemen.  Her independent documentary directorial debut LEMON (2011) about Brooklyn-born poet and performer Lemon Andersen was executive produced by Impact Partners and Russell Simmons, shown at some 40 festivals around the world, selected for U.S. State Department’s 2014 American Film Showcase, and broadcast on PBS stations nationwide. Levison got her start in television working for HBO, PBS, Sundance Channel, and others.  She is on the producing faculty with the MFA program in Social Documentary Film at the School of Visual Arts (SVA), consults on a range of documentary films, and is based in New York City.


December 31, 1969

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Festivals & Awards

Hot Docs International Film Festival


In December 2008, police were called to the Manhattan loft of young, talented photographer Ruth Litoff. They’d never seen anything like it. Surrounded by 15 notes and specially selected gifts for her closest friends, she had killed herself. Years later, her sister Hope attempts to confront why someone so accomplished and loved would take her own life. Working like a detective, she empties the storage locker of all Ruth’s artwork and belongings. Filming every step of her analytical process, the camera observes Hope’s painstaking reconstruction of each day, journal entry and prescription bottle leading to the fateful event. A rich blend of photos, interviews and home movies brings the sisters’ closeness and secrets to life. But while looking for elusive answers, Hope risks her own relationships with friends, her daughter and her hard-won sobriety. Elegantly crafted and deeply moving, this original work plumbs the tensions and strengths of the sibling bond. Myrocia Watamaniuk

+ Festival Website



+ Festival Website



Years after the suicide of her sister Ruth, a talented but troubled artist, director Hope Litoff tries to make sense of her loss. Renting a studio, Hope begins a meticulous forensic investigation of the belongings Ruth left behind, filling the space with her artwork, diaries, datebooks and a pharmacy’s worth of prescription-drug bottles. Confronting her grief yields no simple answers and instead threatens to lead Hope on a precarious collision course with her own inner demons.

+ Festival Website


Even as I write this, I’m still haunted by the experience of watching 32 PILLS.”

-Film Independent

A poignant story of two sisters, a subtle portrait of the connection between mental illness and art and also a revealing look at the perils of personal filmmaking…devastatingly sad but ultimately redeeming.”


Outreach Resources

32 PILLS Film Resources

The filmmakers have compiled resources for viewers, including an audience guide and mental health organizations. 

+ Resources