If Karam had not won the Skip Barber School Shootout in Sebring, Fla., five years later, he might be thinking about wrestling in college, as his father did, rather than eyeing the Indianapolis 500.
Those two events proved pivotal in the direction Karam's life has taken over the past decade — and where it could be going.
When Karam, 18, drives in the Firestone Indy Lights Series race at the Grand Prix of Baltimore on Sunday, he will be chasing 21-year-old points leader Carlos Munoz of Brazil and 20-year-old Gabby Chavez of Colombia, one of his Schmidt Peterson Motorsports teammates, for the overall championship of open-wheel racing's Triple-A.
A win on Pratt Street would be Karam's third this season, would put him in position to win the overall championship and might make it impossible for team owner Sam Schmidt not to give Karam an IZOD IndyCar Series ride next season.
After dominating the USF2000 as a 15-year-old, Karam won twice in his first season in the Pro Mazda Championship and three times last year, including in Baltimore a day after crashing and finishing 15th.
"It's always tough going up to the next level, being a rookie in this series and going up against good guys," Karam said shortly after winning the Milwaukee Mile in June, his first Indy Lights victory. "I think the biggest thing is just to have confidence. You can't be down in any sport that you do.
"Your [racing team] team is not going to work for somebody who doesn't have confidence and doesn't believe he's going to win. Even when times have gotten rough, I've always tried to have fun racing and always stay confident and believe that good things are going to happen."
The first driver to win on all three levels of IndyCar's of Mazda Road to Indy developmental series, Karam nearly had to quit following his dream because of the financial reality that comes with racing — and fixing — expensive race cars.
Karam can recall showing up to races with his car in the bed of his father Jody's pickup truck while others "had almost an IndyCar trailers for go-karts."
Unable to break into the top 10 in karting nationally since starting out at age 4 — "We had to lie and say he was 5," his father said — the then 8-year-old Karam was given his first ultimatum going into the "Stars of Karting" competition on the infield at Charlotte International Speedway.
"If you don't win, we're done racing," Jody Karam, a high school teacher and wrestling coach in Bethlehem, Pa., told his son ominously as they drove down to Charlotte.
The younger Karam won both races that weekend.
"I just won out of nowhere," Sage Karam recalled. "That's when I figured out, 'Hey, maybe that's what I should do.' I think it hit us both. We made a lot of sacrifices to make it happen."
It was hard to distract Karam from racing. The family lived across the street in Nazareth from racecar driver and now team owner Michael Andretti in what Jody Karam calls "Racetown USA," a place where he says he still "gets goosebumps" when he sees the racing family's patriarch, Mario Andretti, walking down the street.
Jody Karam — who also worked as a personal trainer for Michael Andretti — said that while living in close proximity to a racing legend and his family made the dream a little more real for his son, the financial burden the sport put on his own family was also hard to ignore.
Despite continued success in karting, the Karams reached another breaking point when their son was 13.
But then Karam — one of more than 51 drivers ranging from ages 13 to 22 invited to the Skip Barber Shootout — earned a one-year scholarship worth $58,000 from the Skip Barber Racing School.
The scholarship was based on both his on- and off-track performance, which included everything from timed events to how he conducted a television interview. He was the youngest winner ever.
"We knew we might be on to something," Jody Karam said.
Karam's performance at Skip Barber attracted interest from a number of sponsors. Michael Fux, a racing enthusiast who owns the New Jersey-based Comfort Revolution mattress company, has been Karam's biggest sponsor ever since.
"Honestly, we wouldn't be here at this point if it weren't for him," the elder Karam said of Fux. "He saw our needs, he saw our son's talent and he decided to step in and help out. A lot of people say they're going to help out, but Michael is the one of few who has made the difference."
Fux has helped other drivers early in their careers, including reigning Indy 500 champion Tony Kanaan, "but I haven't gotten involved like I have with Sage," Fux said last week. "He was the real deal from the start. He has the right look, but he has a good heart on top of that."
Along with the financial commitment, Fux has encouraged Karam to become involved in charities and took the teenager with him to Honduras to help work with Operation Smile.
"I want him to be someone kids look up to," Fux said.
Fux's involvement has helped ease the financial pressures, but it hasn't lessened the expectations that are now heaped on Karam. He has been forced to balance his life as a high school student and athlete with his blossoming career on the racetrack. He moved to Indianapolis earlier this year but plans to return home and wrestle his senior season when the racing season ends.
"It's definitely tough," Karam said. "A lot of people say I live such a different life than a normal 18-year old kid. I try to be a normal kid as much as I can, but at the same time what I'm trying to do is be a part of a professional sport. It's definitely tough to manage my time. As long as I can manage my grades, everything will be OK."
The family's relationship with the Andrettis has been strained since Fux took Karam to Schmidt Peterson Motorsports when he couldn't get the contract he wanted from Andretti Autosports, which sees Munoz, who finished second in this year's Indy 500, as its next big star.
"I wanted to keep him with Andretti. I offered Michael the opportunity to meet me on a financial basis and take a little risk on Sage and they said, 'No,'" Fux said. "Sam Schmidt was willing to. It turned out to be a really good move. Sage has learned a lot with Sam and his people."
Through an Andretti Autosports spokeswoman, Michael Andretti said he is “disappointed that Sage and Michael Fux feel as though [I] wouldn’t work with them to put something together for Sage.”