re: I need some advice from the financial gurus

As others said, selling car w a lien is a common occurrence. Before going private sale route, also look into selling via carmax, Carvana… or whoever else is out there. They can deal w the lien, handle all paperwork, and give you a decent price.

I’d try playing the 0% cc game for awhile before touching retirement money. Even as much as applying for new cc w 0% financing for 12/18 months. I’d also ask around about bank loans to payoff all the cc and agree to cut them up. You can always get new ones later.

For future medical debt, look into having them bill you for the services instead of credit cards. I have heard you can negotiate the amounts better after the fact, and you can often stretch them out by making very minimal payments.