He was sent to New York in the early twentieth century to counteract Lasombra power over that city, and rallied the disenfranchised intellectuals to his banner - naturally, his Tzimisce kin were among these, but also Toreador and Ventrue antitribu, some Serpents of the Light, and even the reclusive Tremere antitribu.
With Carême as Priscus, the Pack priests finally had an authority with whom they could lend strength to their purpose. While Ecaterina played as moderator between Carême and Polonia, supporting the status quo, Carême was responsible for a spiritual reform among the sect, spreading the Paths of Enlightenment among the native packs of North America. By the 1920s, many Sabbat had turned successfully from wanting humanitas to one of the more suitable Paths.
In 1953, Carême left the city of his own accord and resigned the title of priscus, but reclaimed it ten years later to become Velya's apprentice in the Old World, a position he retains to the Final Nights. His degenerate childe, Ladislav Ciorbea, stayed in New York after the departure of his sire - and some even argue that the factors brought by Carême's intervention, as well as the fanatical behavior of his childe in later events, would cause the beginning of the third Sabbat Civil War.