As neural methods are increasingly used to support and automate software development tasks, code review is a natural next target. Yet, training models to imitate developers based on extant code reviews is far from straightforward: reviews found in open-source projects vary greatly in quality, phrasing, and depth depending on the reviewer. In addition, changesets are often large, stretching the capacity of current neural models. Recent work reported modest success at predicting review comments and their resolution, but largely side-stepped the above issues by focusing on short comments in small inputs where comments were already known to occur. This work examines the vision and challenges of automating code review at realistic scale. We collect hundreds of thousands of changesets across hundreds of projects that routinely conduct code review, many of which change thousands of tokens. We focus on predicting just the locations of comments, which are quite rare. By analyzing model performance and dataset statistics, we show that even this task is already challenging, in no small part because of tremendous variation and (apparent) randomness in code reviews. Our findings give rise to a research agenda for realistically and impactfully automating code review.