The Rev. Bob LaForce doesn't mince words when he prays for people's healing. He will "stand before" a fever. He will "rebuke" cancer cells. He will "come against" back pain. Even with some ailment of the soul such as pride, he will pray not that it be diminished but that it be "crucified."

His confident, charismatic style of prayer--which beseeches full healing and not just acceptance and comfort--emanates from the scripture-based belief that "as children of God, we have the power to come against sickness and disease in the name of Jesus."

Why are some healed and others not? "It's a mystery" that happens "all in God's timing, in His plan."

LaForce, the pastor of the conservative, evangelical Bethesda Presbyterian Church in Bustleton, Pennsylvania, believes such prayers are biblically mandated, regardless of their outcome, and he offers them often. With the elders, he visits, anoints, and prays for the sick. On the spot, he prays over the phone with anyone calling to request it. And as a substitute host on a local Christian radio talk show, he prays over the air for the concerns of listeners.

Twice monthly, a "healing line" of four or five people forms at the front of the pastor's church after Sunday worship. There is no formal rite or ritual, but Mr. LaForce usually places his hands on the head of the person seeking prayer and asks what brings him there.

"There aren't colds or broken fingernails," he said, but often debilitating conditions that have persisted.

The pastor asks questions, trying to discern the nature and cause of the pain.

"What is the person really struggling with?" he asks himself. "Sometimes a pain may show there's something else going on. Our job is not just to rebuke it. She may need a physician or surgery."

As a church elder anoints the person with holy oils, the pastor lays his hands on the afflicted area and prays that the problem and its underlying cause go away. He weaves scripture passages through his prayer, often using words from Exodus 15:26 ("I am the Lord who heals you"), or from John 8:36 ("If the Son sets you free, you will be free indeed"), or Isaiah 10:27 ("The anointing breaks the yoke of bondage").

Much of what he does is "common sense," he said. His prayer does not substitute for medical help, and he may even suggest it.

But his is also the world of the spirit, and much of his work--choosing a prayer, selecting a scripture passage, deciding what questions to ask--he considers to be prompted by an internal voice, sometimes referred to as a "word of knowledge," that he recognizes as the Holy Spirit.

One woman came recently complaining of pains in her legs. "Right away the Lord was saying to me, 'It's only this one leg,'" he recalled. When he asked the woman to be more specific, she indeed identified the pain as affecting only the one leg.

Sometimes relief comes immediately, sometimes gradually.

The sick person needn't be physically present for the prayer, or agree to be prayed for, or even a believer, for healing to take place, said the pastor. The most remarkable healing he has seen happened a year ago when he was praying over a woman with intractable back pain. "I saw her whole skeletal structure just lift up off her and float up into the air--you could see through it--and it disappeared," and she was free of pain, he said.

Why are some healed and others not? "It's a mystery" that happens "all in God's timing, in His plan.. There are just as many reasons why someone might not be healed as there are lives. God may still have something He wants to do in that individual's life."

Healing has nothing to do with individual merit or spiritual fervor, he said, but happens "because of the richness of His mercy and grace. We should always come with faith, but I don't think the amount of faith is the issue, either. We should come empty of ourselves. I try to get people to look past the situation and focus on Jesus."

Healing has nothing to do with individual merit or spiritual fervor but happens "because of the richness of His mercy and grace."

As for whether it is the Lord or the doctors who do the healing, Mr. LaForce said, "it's not that the Holy Spirit just comes down. God can take radiation therapy or chemotherapy and use it for His glory and that person will be healed."

But the pastor doesn't believe that a person is doomed without medical intervention.

"Nothing is impossible with God," he said, quoting Luke 1:37.

While LaForce believes that prayer can make life and ailments immensely more bearable, he believes neither medicine nor prayer ultimately changes the timing of a person's hour of death.

"I personally believe the Lord has one time for each of us to die, and that it is appointed in history" and not affected by prayer, he said.

The 47-year-old pastor, though the son of a Presbyterian church elder, said he "never knew Jesus" as a child. He might have found another line of work altogether had he not missed the application deadline for Gettysburg College and wound up at a Christian college in New England instead.