I would really discourage you from drawing upon your retirement account. Following Dave Ramsey has helped me. It's great that you want to help your kids with their driving expenses, but there is an opportunity for them to take responsibility and figure out how they can help with the insurance costs.

With ER visits, you can set-up a payment plan with the medical providers.

At least you have a retirement account. I'll probably be working until I'm in my mid 70s. Can your wife find better employment before your job ends? As far as the distance you are having from your wife, that sounds awful. I would let her know that you want to have a partnership and ask her what you need to do to re-build your relationship.

Shop around for van tires. NextDoor may have some recommendations. I also met my current best friend from posting on the NextDoor app.