Back in 2001 an American airlines 767 diverted into Stornoway (An island off Scotland) for a medical emergency.
http://www.pprune.org/rumours-news/1...stornoway.html
I would not go into Stornoway with an engine failure let alone a medical emergency although I'm not saying the AA crew were wrong. Just different opinions between professional pilots.
Similarly if Kangerlussuaq airport (Formerly known as Sondrestrom) had a strong westerly wind and I had an engine out I would rather find a more suitable airport even if it was slightly further away.
The nearest strip of concrete you can land on is not necessarily the nearest suitable. If you are on fire then yes it is. If you are at 30,000 feet and have an engine failure an airport 90 miles ahead of you is just as suitable as one right below you.
The nearest suitable airport is a deliberately vague term to allow the pilot to decide on the day what is suitable in relation to the condition he is in. Medical emergency, bomb threat, engine fire, engine failure all have slightly different considerations.