Tutto Passa - Embracing Impermanence (2024)

New Years Edition

‘Tutto Passa’ Ciro Pipoli

There’s nothing right now that I hold on to so dearly that I would want permanently etched on my body in the form of a tattoo. However, if I decided to get one, my first tattoo would be this Italian phrase I’ve fallen in love with - Tutto Passa

Tutto Passa is an Italian expression that translates to ‘everything passes’ in English. It describes the impermanence of life and how nothing is truly free from the constant flow of life. Tutto Passa is usually used in a somber tone, perhaps to describe loss - loss of family/friends, loss of a relationship, loss of youth (aging). 

I’m no Buddhist, but most of us, including myself, don't notice life’s impermanence until it is shoved in our faces. We may agree with the truth of impermanence, yet we behave as though everything is permanent. This thought stood out to me as I was writing my goals for the new year. I realized that I was invested in the idea that I was in control of my nutrition, workout plans, hobbies, and career direction. At the center of this feeling is the fact that I’m an agent, responsible for all of these actions, yet still have no control; can still be manipulated by my mind, and still be diseased by my own body.

On a fundamental level, our cells, particularly cellular DNA, face existential threats daily from endogenous and exogenous sources of damage. Over the years, the human body has evolved repair pathways to fix some of these damages. (Thanks to the pioneering work of Tomas Lindahl, Paul Modrich, and Aziz Sancar who shared the 2015 Nobel Prize in chemistry). However, errors may occur if specific DNA repair & checkpoint pathways are inactivated, or if the damage load overwhelms DNA's restorative capacity. These errors lead to mutations and carcinogenesis (cancer). This introduces the question of the probability of getting cancer from these mutations. 

In a paper published in 2015 by researchers at Johns Hopkins Medicine titled ‘Variation in cancer risk among tissues can be explained by the number of stem cell divisions’. They created a statistical model that measures the proportion of cancer risk across many tissue types caused mainly by random mutations from stem cells. They theorized that bad luck of random mutations plays a predominant role in about two-thirds of cancer risk in adults, while the remaining third is due to environmental and human/genetic factors. While there is no single risk factor that causes cancer but a combination of factors, some risk factors for cancer are outside our control. 

So if a lot of things are out of our control, how do we live our lives knowing that things could all change in a flash? Do we worry less and act every day like it is our last? In my day job, I am often directly faced with life’s impermanence by cancer patients, a constant reminder that life is finite. Sometimes I create simple radiation treatment plans for senior patients receiving palliative care and it brings a subtle level of sadness within me. It brings a more complicated perspective on the time frame of my life. I’ve slowly lost my innocence due to being super aware of my mortality and how inevitable it is. The positive in this case would be that accepting this truth opens me up to a more vivid present experience, one where I'm truly grateful for my time here, continuously releasing the restrictions of fears and allowing me to bask in the moment. What is the worst that could happen?  

I remember in 2020 when COVID-19 brought the fickleness of our plans close to home; - I remember hitting rock bottom twice in 2022. All of these reiterate that everything passes. Embracing impermanence means we prepare ourselves for changes and can let go of our anxiety to become fully present. My goal this year as it relates to Tutto Passa is to live life like everything is rigged in my favor and in my quest to do that, I will procrastinate less and execute more. Understanding what is within my control and acting on it. I’m not sure what life would bring or what is to come but my best bet is to appreciate this precious time and enjoy the beauty in every moment. 

Optimistically, adopting a stoic approach to how events turn surely makes this approach a little less intimidating, and spending more time with family and friends makes it all worth it at the end of the day. To quote Marcus Aurelius -

‘Life for each of us is a mere moment, and this life of yours is nearly over, while you still show yourself no honor, but let your welfare depend on other people’s souls’

Life’s constant flux can provoke stress, frustration, and sadness in some situations. Yet when we embrace this ever-changing nature, life transforms into a source of joy. We learn to value the poignant beauty of our fleeting existence. I’d love to hear how you’d apply Tutto Passa this year.