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Leading Through the Messy Middle
- kaitlinlpettit
- 2 days ago
- 2 min read
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What do you do when there isn’t a clear answer yet?
That question came up again and again in a recent conversation with Dr. Bill Hilty, emergency physician, longtime Toilet Equity board member, and someone who spends a lot of time making decisions in situations where certainty simply isn't available.
In emergency medicine, patients don't always arrive with clear diagnoses. Sometimes the first job is simply to stay calm, stabilize what you can, and resist the urge to panic.
As Bill put it:
"Sometimes you have to start. You can correct. But if you don't start, nothing happens."
As he talked, the conversation wandered from emergency rooms to compost piles, nonprofit leadership, and the challenge of navigating  "the messy middle": that uncomfortable space between identifying a problem and finding a solution.
It turns out there are surprising parallels between all of them.
Bill shared his thoughts on:
Why good leaders "take their own pulse first"
How teams function during uncertainty
The difference between action and reaction
Why consensus can be messy, but valuable
What compost, healthcare, and community change have in common
And perhaps most importantly, why meaningful transformation rarely happens overnight.
Whether you're leading an organization, supporting a cause you care about, or simply navigating uncertainty in your own life, we think you'll find something worth reflecting on in this conversation.
Thank you for being part of this thoughtful, compassionate community. The work of building healthier communities, like the work of composting, often takes patience, persistence, and people willing to stay engaged through the messy middle.
We're grateful you're here.
With gratitude,
The Toilet Equity Team
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This article originally appeared in our June 2026 email newsletter. You can subscribe to receive future updates here.