The way in which people approach ill health and its relief is often explained as a function of pragmatic evaluation. Through looking at a case of illness in the family of David Kaso, a Baptist pastor living in rural Malawi, this article suggests that trust or faithfulness may be more appropriate terms with which to describe people's approaches to healing and their social antecedents and outcomes. Pentecostal churches had grown in influence in the area where the churches David led were located. Pentecostal leaders often emphasized that experiencing divine healing, or successfully bringing it about, were the results of the ‘work’ that Christians did for God. David and his congregants recognized the difficult questions this perspective could raise about their status in church and emphasized instead that healing happened in God's ‘grace’, largely irrespective of the actions of the Christian. This being the case, the efficacy of prayer as a way of bringing about healing could not really be tested nor, as a corollary, could the outcome of prayer for healing stand as a proxy for evaluating the Christian. The uncertainties David and his church members admitted over healing meant that the basis of their relationships was better described in terms of trust or faithfulness than pragmatism.